Individual provider Active NPI

Janey Lynne Hardesty, FNP

  • Family Nurse Practitioner
  • Mishawaka, IN
National Provider Identifier
1881194751
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71007896A Issued in IN
Practice address
611 E Douglas Rd Ste 208
Mishawaka, IN 46545
Phone
(574) 335-6700
Fax
(574) 335-0726
NPI assigned
Feb 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71007896A IN Primary

Addresses

Primary practice location

611 E Douglas Rd Ste 208
Mishawaka, IN 46545

Mailing address

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469

Other identifiers 1

IdentifierTypeStateIssuer
300013265MedicaidIN

Other names 1

  • Janey Lynne Elliott Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180504001396 IN Practitioner - Nurse Practitioner 1759645468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Joseph Regional Medical Center IncGroup PAC ID 8325950843, 137 clinicians

Practice addresses (Care Compare)

1122 S Ironwood Dr
River Park Family Medicine
South Bend, IN 46615-1618
Phone (574) 335-8399

2930 W Cleveland Rd Ext
Northwest Family Medicine
South Bend, IN 46628-6090
Phone (574) 335-8450

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469

60101 Bodnar Blvd
Suite 100B
Mishawaka, IN 46544-9340
Phone (574) 335-8800

611 E Douglas Rd
Mishawaka, IN 46545-1465

611 E Douglas Rd
Mishawaka, IN 46545-1467

611 E Douglas Rd
309 Infectious Diseases
Mishawaka, IN 46545-1469
Phone (574) 335-6770

616 E 13TH St
Cardiology Winamac
Winamac, IN 46996-1117
Phone (574) 948-5340

Hospital & facility affiliations

  • Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012

National Provider Directory

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

Organizations & group practices 1

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 2

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": "1518825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1881194751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD STE 208",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "46545",
            "telephone_number": "574-335-6700",
            "fax_number": "574-335-0726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDESTY",
        "first_name": "JANEY",
        "middle_name": "LYNNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-17",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007896A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300013265",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANEY",
            "last_name": "ELLIOTT",
            "middle_name": "LYNNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mishawaka, IN

Sources for this page

Verify at the official NPI Registry.