Active NPI
Angela J Hardy, PA
- Medical Physician Assistant
- MC Rae, GA
National Provider Identifier
1972977684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 2414
- Practice address
- 10 North 3Rd Avenue
MC Rae, GA 31055 - Phone
- (229) 868-2831
- NPI assigned
- Nov 18, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 2414 | GA | Primary |
Addresses
Primary practice location
10 North 3Rd Avenue
MC Rae, GA 31055
Mailing address
10 North 3Rd Avenue
MC Rae, GA 31055
Phone (229) 868-2831
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2414 | Other | GA | PA LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2414 | GA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447804800000",
"number": "1972977684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 NORTH 3RD AVENUE",
"city": "MC RAE",
"state": "GA",
"postal_code": "31055",
"telephone_number": "229-868-2831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 NORTH 3RD AVENUE",
"city": "MC RAE",
"state": "GA",
"postal_code": "31055",
"telephone_number": "229-868-2831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARDY",
"first_name": "ANGELA",
"middle_name": "J",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-11-18",
"last_updated": "2015-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "GA",
"license": "2414",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA LICENSE",
"identifier": "2414",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in MC Rae, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.