Charlie M Hardin Jr, CFNP/ACNP is a medicare enrolled "Nurse Practitioner - Acute Care" in Walnut Grove, Mississippi. He graduated from nursing school in 2003 and has 22 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Baptist Medical Center-leake, Inc. and his current practice location is
110 Park Street, Walnut Grove, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(601) 253-0173.
Charlie M Hardin Jr is licensed to practice in Mississippi (license number R857156) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1669450037.
Provider's Profile
| Full Name | Charlie M Hardin Jr |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 22 Years |
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| Location | 110 Park Street, Walnut Grove, Mississippi |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Charlie M Hardin Jr graduated from nursing school in 2003
NPI Data:
- NPI Number: 1669450037
- Provider Enumeration Date: 01/05/2006
- Last Update Date: 03/07/2018
Medicare PECOS Information:
- PECOS PAC ID: 8628049681
- Enrollment ID: I20040803001282
Medical Identifiers
Medical identifiers for Charlie M Hardin Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1669450037 | NPI | - | NPPES |
| 03239875 | Medicaid | MS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LA2100X | Nurse Practitioner - Acute Care | R857156 (Mississippi) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Baptist Medical Center-leake, Inc. | 7214102961 | 15 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Charlie M Hardin Jr allows following entities to bill medicare on his behalf.
| Entity Name | Independent Healthcare Management Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1306909734
PECOS PAC ID: 0840197232
Enrollment ID: O20031215000487 |
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| Entity Name | Baptist Medical Center-leake, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1356626618
PECOS PAC ID: 7214102961
Enrollment ID: O20120112000444 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Charlie M Hardin Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Charlie M Hardin Jr, CFNP/ACNP
965 Ridge Lake Blvd Ste 103,
Memphis, TN 38120-9446
Ph: (901) 227-3255 | Charlie M Hardin Jr, CFNP/ACNP
110 Park Street,
Walnut Grove, MS 39189
Ph: (601) 253-0173 |
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