Individual provider Active NPI

Edward H. Hardison III, MD

  • Pediatric Cardiology Physician
  • Salt Lake City, UT
National Provider Identifier
1760944631
Registry record updated Mar 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
13284713-1205 Issued in UT
Practice address
81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125
Phone
(801) 581-2121
NPI assigned
Apr 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 13284713-1205 UT Primary

Addresses

Primary practice location

81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125

Mailing address

81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125
Phone (801) 581-2121

Other practice location 1

1313 21st Ave S Ste 500
Nashville, TN 37232-0001
Phone (615) 936-8590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230314001696 UT Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 2365879079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13284713-1205UTMDPediatric Cardiology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677888000000",
    "number": "1760944631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 N MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131125",
            "telephone_number": "801-581-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 N MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131125",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1313 21st Ave S Ste 500",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372320001",
            "country_code": "US",
            "telephone_number": "615-936-8590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDISON",
        "first_name": "EDWARD",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2023-03-04",
        "certification_date": "2023-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "UT",
            "license": "13284713-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.