Individual provider Active NPI

Jason Lamarr Hardin, MSN, APRN, AGNP-C

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1932675758
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5011129 Issued in NC
Practice address
6010 E W T Harris Blvd
Charlotte, NC 28215-4084
Phone
(704) 208-4134
Fax
(704) 248-8068
NPI assigned
Oct 18, 2018
Last updated
Mar 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5011129 NC Primary
Infectious Disease Physician 207RI0200X 5011129 NC

Addresses

Primary practice location

6010 E W T Harris Blvd
Charlotte, NC 28215-4084

Mailing address

6010 E W T Harris Blvd
Charlotte, NC 28215-4084
Phone (704) 208-4134

Other practice location 1

16147 Lancaster Hwy Ste 140
Charlotte, NC 28277-4782
Phone (704) 208-4134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190923000809 NC Practitioner - Nurse Practitioner 2264762012 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5011129NCMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amity Medical Group, Inc. Family Medicine CurrentSince Aug 1, 2019 Accepting new patients
Ballantyne Family Medicine PC Family Medicine Current Accepting new patients

Locations

10508 Park Rd
Ste 130
Charlotte, NC 28210
Phone (704) 208-4134

16147 Lancaster Hwy
Ste 140
Charlotte, NC 28277
Phone (704) 208-4134

6010 E Wt Harris Blvd
Charlotte, NC 28215
Phone (704) 208-4134

Interoperability endpoints

  • Direct secure messaging: jason.hardin.1@12616.direct.athenahealth.com

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": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1932675758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6010 E W T HARRIS BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282154084",
            "telephone_number": "704-208-4134",
            "fax_number": "704-248-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 E W T HARRIS BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282154084",
            "telephone_number": "704-208-4134",
            "fax_number": "704-248-8068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16147 Lancaster Hwy Ste 140",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282774782",
            "country_code": "US",
            "telephone_number": "704-208-4134",
            "fax_number": "704-248-7845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDIN",
        "first_name": "JASON",
        "middle_name": "LAMARR",
        "name_prefix": "Mr.",
        "credential": "MSN, APRN, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-18",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5011129",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NC",
            "license": "5011129",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.