Individual provider Active NPI

Stephen P Hardy, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Missoula, MT
National Provider Identifier
1790735058
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
9593 Issued in MT
Practice address
2802 Great Northern Loop
Missoula, MT 59808-1738
Phone
(406) 728-3811
Fax
(406) 721-9141
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 9593 MT Primary

Addresses

Primary practice location

2802 Great Northern Loop
Missoula, MT 59808-1738

Mailing address

2802 Great Northern Loop
Missoula, MT 59808-1738
Phone (406) 728-3811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20060926000548 MT Practitioner - Plastic and Reconstructive Surgery 7214932243 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9593MTMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt CurrentSince Dec 1, 2013 Accepting new patients
Providence Health & Services Mt Current Accepting new patients
Northwest Plastic Surgery Associates, PLLC Plastic and Reconstructive Surgery Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Providence Health & Services Mt Past Accepting new patients

Locations

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

500 W Broadway St
Fl 4
Missoula, MT 59802
Phone (406) 327-1900

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

Organizations & group practices 5

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1790735058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2802 GREAT NORTHERN LOOP",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081738",
            "telephone_number": "406-728-3811",
            "fax_number": "406-721-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 GREAT NORTHERN LOOP",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081738",
            "telephone_number": "406-728-3811",
            "fax_number": "406-721-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "STEPHEN",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MT",
            "license": "9593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.