Individual provider Active NPI

Anne Marie Hardy, APRN

  • Family Medicine Physician
  • Mount Vernon, WA
National Provider Identifier
1871061606
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
AP60913504 Issued in WA
Practice address
1420 Roosevelt Ave Ste 4
Mount Vernon, WA 98273-2687
Phone
(360) 899-4086
Fax
(360) 899-4124
NPI assigned
Nov 9, 2018
Last updated
May 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN00122254 WA
Family Medicine Physician 207Q00000X AP60913504 WA Primary

Addresses

Primary practice location

1420 Roosevelt Ave Ste 4
Mount Vernon, WA 98273-2687

Mailing address

1420 Roosevelt Ave Ste 4
Mount Vernon, WA 98273-2687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20190619000191 WA Practitioner - Nurse Practitioner 4082948419 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN00122254WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Clinic Walk in and Primary Care LLC CurrentSince Mar 2, 2019 Accepting new patients
Premier Diabetes Care, PLLC PastSince Mar 2, 2019 Accepting new patients
Aloha Mental Wellness LLC PastSince Nov 1, 2019 Accepting new patients

Locations

1420 Roosevelt Ave
Ste 4
Mount Vernon, WA 98273
Phone (360) 899-4086

Organizations & group practices 3

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": "1541721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1871061606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 ROOSEVELT AVE STE 4",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 ROOSEVELT AVE STE 4",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732687",
            "telephone_number": "360-899-4086",
            "fax_number": "360-899-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "ANNE",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-09",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00122254",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "AP60913504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.