Individual provider Active NPI

Bruce Edmond Hardwick, LMSW

  • Social Worker
  • Prescott, AZ
National Provider Identifier
1821199050
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1953SW Issued in AZ
Practice address
500 N Highway 89
VA Medical Center
Prescott, AZ 86313
Phone
(928) 445-4860
Fax
(928) 776-6138
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1953SW AZ Primary

Addresses

Primary practice location

500 N Highway 89
VA Medical Center
Prescott, AZ 86313

Mailing address

324 Cochise St
Prescott, AZ 86303-3506
Phone (928) 445-3496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1953SWAZMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821199050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 COCHISE ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863033506",
            "telephone_number": "928-445-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N HIGHWAY 89",
            "address_2": "VA MEDICAL CENTER",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86313",
            "telephone_number": "928-445-4860",
            "fax_number": "928-776-6138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDWICK",
        "first_name": "BRUCE",
        "middle_name": "EDMOND",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "1953SW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.