Individual provider Active NPI

Gary Randall Hardee, M.D.

  • Family Medicine Physician
  • Dimmitt, TX
National Provider Identifier
1841384690
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F9533 Issued in TX
Practice address
300 W Halsell St
Dimmitt, TX 79027-1846
Phone
(806) 647-2194
Fax
(806) 647-3769
NPI assigned
Oct 3, 2006
Last updated
Jan 29, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X F9533 TX Primary

Addresses

Primary practice location

300 W Halsell St
Dimmitt, TX 79027-1846

Mailing address

300 W Halsell St
Dimmitt, TX 79027-1846
Phone (806) 647-2194

Other identifiers 4

IdentifierTypeStateIssuer
458679OtherTXMEDICARE GROUP
130796901MedicaidTX
114547102OtherTXFIRSTCARE
00GE14OtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070206000549 TX Practitioner - Family PracticePractitioner - Emergency Medicine 1153323076 Practice locations: Dimmitt, TX

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Honor Services,Inc. Past Accepting new patients
Cambridge LTC Partners, Inc. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1841384690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W HALSELL ST",
            "city": "DIMMITT",
            "state": "TX",
            "postal_code": "790271846",
            "telephone_number": "806-647-2194",
            "fax_number": "806-647-3769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HALSELL ST",
            "city": "DIMMITT",
            "state": "TX",
            "postal_code": "790271846",
            "telephone_number": "806-647-2194",
            "fax_number": "806-647-3769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDEE",
        "first_name": "GARY",
        "middle_name": "RANDALL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F9533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "458679",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130796901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "114547102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00GE14",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dimmitt, TX

Sources for this page

Verify at the official NPI Registry.