Individual provider Active NPI

David Burton Hardin, MD

  • General Practice Physician
  • Indianapolis, IN
National Provider Identifier
1801836069
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
01039780A Issued in IN
Practice address
8355 Rockville Rd Ste 120
Indianapolis, IN 46234-2722
Phone
(317) 429-0061
Fax
(317) 222-1953
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 01039780A IN Primary
Physical Medicine & Rehabilitation Physician 208100000X 44907 TN
Physical Medicine & Rehabilitation Physician 208100000X 01039780A IN
Internal Medicine Physician 207R00000X 01039780A IN

Addresses

Primary practice location

8355 Rockville Rd Ste 120
Indianapolis, IN 46234-2722

Mailing address

635 S Earl Ave
Ste B
Lafayette, IN 47904-3603
Phone (765) 838-8208

Other practice location 1

635 S Earl Ave
Ste B
Lafayette, IN 47904-3603
Phone (765) 838-8208

Other identifiers 2

IdentifierTypeStateIssuer
100180760AMedicaidIN
6487340900MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20031117000408 IN Practitioner - Physical Medicine and Rehabilitation 9739093550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael S Miller DO Facos CWS PCGroup PAC ID 6406935733, 6 clinicians

Practice addresses (Care Compare)

3850 Shore Dr
Suite 315
Indianapolis, IN 46254-4693
Phone (317) 429-0061

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44907TNMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Informe Healthcare LLC Internal Medicine CurrentSince Nov 6, 2020 Accepting new patients
Wellmont Physician Services Inc Internal Medicine Past Accepting new patients
Lafayette'S Wound Center, LLC Internal Medicine Past Accepting new patients

Locations

745 N Swope St
Greenfield, IN 46140
Phone (317) 462-9221

17475 Dugdale Dr
South Bend, IN 46635
Phone (574) 247-7500

2741 W Layton Ave
Ste 106
Milwaukee, WI 53221

Organizations & group practices 4

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1801836069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 S EARL AVE",
            "address_2": "STE B",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479043603",
            "telephone_number": "765-838-8208",
            "fax_number": "765-838-8207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8355 ROCKVILLE RD STE 120",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462342722",
            "telephone_number": "317-429-0061",
            "fax_number": "317-222-1953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "635 S Earl Ave",
            "address_2": "STE B",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479043603",
            "country_code": "US",
            "telephone_number": "765-838-8208",
            "fax_number": "765-838-8207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDIN",
        "first_name": "DAVID",
        "middle_name": "BURTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01039780A",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "44907",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "01039780A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01039780A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100180760A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6487340900",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.