Lori Lynne Hardacker, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4617 Issued in AZ

Practice address

13555 W McDowell Rd
Suite 101
Goodyear, AZ 85395-2624

Phone

(623) 935-4700

Fax

(623) 935-4707

NPI assigned

Jun 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Robert P Luberto DO PC

  • Sports Medicine (Family Medicine) Physician
  • Peoria, AZ
  • NPI 1144365420
  Medicare reassignment
• Privia Medical Group Arizona, LLC

  • Family Medicine Physician
  • Payson, AZ
  • NPI 1740459700
  NPD (past)
• Privia Medical Group Arizona, LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1760441141
  NPD (past)

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362960000000",
    "number": "1780612952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 N. 3RD ST",
            "address_2": "SUITE 4010",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85020",
            "telephone_number": "602-633-3838",
            "fax_number": "602-633-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13555 W MCDOWELL RD",
            "address_2": "SUITE 101",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952624",
            "telephone_number": "623-935-4700",
            "fax_number": "623-935-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDACKER",
        "first_name": "LORI",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2013-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "526932",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Loriel Handlen, PA-C
• Russell S. Hanks, PHYSCIAL THERAPIST
• Abboud Hanna, M.D.
• Deserae Hanna, BCBA, LBA
• Shelley A Hanson, LPC, LMFT
• Lee William Harding, D.D.S.
• Taryn Danielle Harker, PT, DPT
• Harmoni Care Assisted Living LLC
• Effula Harness, CRNA
• Stacey Harper

• Physician Assistant in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.