Individual provider Active NPI

Lauren Nicole Hardy, PA-C

  • Physician Assistant
  • Sikeston, MO
National Provider Identifier
1881009934
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2014020545 Issued in MO
Practice address
102 Hospitality Dr
Sikeston, MO 63801-9382
Phone
(573) 471-0200
Fax
(573) 475-7631
NPI assigned
Jun 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2014020545 MO Primary

Addresses

Primary practice location

102 Hospitality Dr
Sikeston, MO 63801-9382

Mailing address

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-0200

Other practice location 1

1017 N Main St
Sikeston, MO 63801-5043
Phone (573) 472-6030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20150810001588 MO Practitioner - Physician Assistant 7113232802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missouri Delta Medical CenterGroup PAC ID 1355252891, 134 clinicians

Practice addresses (Care Compare)

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-1600

1015 N Main St
Sikeston, MO 63801-5043
Phone (573) 472-7777

1017 N Main St
Sikeston, MO 63801-5043
Phone (573) 472-6030

1019 N Main St
Sikeston, MO 63801-5043
Phone (573) 472-7702

Hospital & facility affiliations

  • Missouri Delta Medical Center Hospital, Sikeston, MO, CCN 260113
  • Baptist Health Louisville Hospital, Louisville, KY, CCN 180130
  • Saint Francis Medical Center Hospital, Cape Girardeau, MO, CCN 260183

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2014020545MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri Delta Medical Center CurrentSince Apr 1, 2019 Accepting new patients
Missouri Delta Medical Center CurrentSince Apr 1, 2019 Accepting new patients
Missouri Delta Medical Center Past Accepting new patients

Locations

1403 E Marshall St
Charleston, MO 63834
Phone (573) 683-2327

1017 N Main St
Sikeston, MO 63801
Phone (573) 472-6030

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1881009934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "573-471-0200",
            "fax_number": "573-471-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HOSPITALITY DR",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638019382",
            "telephone_number": "573-471-0200",
            "fax_number": "573-475-7631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1017 N Main St",
            "address_purpose": "LOCATION",
            "city": "Sikeston",
            "state": "MO",
            "postal_code": "638015043",
            "country_code": "US",
            "telephone_number": "573-472-6030",
            "fax_number": "573-472-6029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDY",
        "first_name": "LAUREN",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-27",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2014020545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sikeston, MO

Sources for this page

Verify at the official NPI Registry.