Individual provider Active NPI

Kristi Joanne Hard

  • Clinical Social Worker
  • Provo, UT
National Provider Identifier
1780179739
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11343628-3502 Issued in UT
Practice address
750 N Freedom Blvd
Provo, UT 84601-1677
Phone
(801) 373-4760
Fax
(801) 373-0639
NPI assigned
Jun 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11343628-3502 UT Primary
School Social Worker 1041S0200X

Addresses

Primary practice location

750 N Freedom Blvd
Provo, UT 84601-1677

Mailing address

750 N Freedom Blvd
Provo, UT 84601-1677
Phone (801) 373-4760

Other practice location 1

1726 Buckley Ln
Provo, UT 84606
Phone (801) 373-6562

Other practice location 2

1726 Buckley Ln
Provo, UT 84606
Phone (801) 373-6562

Other practice location 3

1726 Buckley Ln
Provo, UT 84606
Phone (801) 373-6562

Other identifiers 1

IdentifierTypeStateIssuer
1780179739MedicaidUT

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210818000684 UT Practitioner - Clinical Social Worker 5294130068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wasatch Behavioral Health Special Service DistrictGroup PAC ID 2567367915, 84 clinicians

Practice addresses (Care Compare)

750 N 200
Provo, UT 84601-1677
Phone (801) 373-4760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11343628-3502UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wasatch Behavioral Health Special Service District CurrentSince Aug 10, 2021 Accepting new patients
Wasatch Behavioral Health Special Service District CurrentSince Aug 10, 2021 Accepting new patients

Locations

750 N Freedom Blvd
Ste 300
Provo, UT 84601
Phone (801) 373-4763

1157 E 300 N
Provo, UT 84606
Phone (801) 373-7443

750 N Freedom Blvd
Provo, UT 84601
Phone (801) 373-0639

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1780179739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011677",
            "telephone_number": "801-373-4760",
            "fax_number": "801-373-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011677",
            "telephone_number": "801-373-4760",
            "fax_number": "801-373-0639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1726 Buckley Ln",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "84606",
            "country_code": "US",
            "telephone_number": "801-373-6562",
            "fax_number": "801-375-9225",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1726 Buckley Ln",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "84606",
            "country_code": "US",
            "telephone_number": "801-373-6562",
            "fax_number": "801-375-9225",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1726 Buckley Ln",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "84606",
            "country_code": "US",
            "telephone_number": "801-373-6562",
            "fax_number": "801-375-9225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARD",
        "first_name": "KRISTI",
        "middle_name": "JOANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "11343628-3502",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780179739",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.