DR. LAUREN MARIE HARDISTY (NPI# 1316107766) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316107766 |
| Entity Type | Individual |
| Full Name | DR. LAUREN MARIE HARDISTY |
| Credential | M.D. |
| Practice Address |
5921 W State Road 46 Bloomington IN 47404-9359 |
| Mailing Address |
Po Box 1329 Bloomington IN 47402-1329 |
| Practice Telephone | 8129358866 |
| Practice Fax Number | 8129358860 |
| Mailing Telephone | 8123532154 |
| Mailing Fax Number | 8123535228 |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2017-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 01066379A | IN | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 01066379A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200936080 | 05 |
| Street Address |
5921 W STATE ROAD 46 |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47404-9359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922002898 | Jennifer Kay Winders | Family Medicine | 5921 W State Road 46, Bloomington, IN 47404-9359 | 2005-06-09 |
| 1285140285 | Amanda Eller | Registered Nurse | 5921 W State Road 46, Bloomington, IN 47404-9359 | 2017-12-28 |
| 1225437312 | Karmen Dayhuff | Nurse Practitioner | 5921 W State Road 46, Bloomington, IN 47404-9359 | 2014-08-14 |
| 1497891840 | Michael William Kane | Family Medicine | 5921 W State Road 46, Bloomington, IN 47404-9359 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013526631 | Sandra Clark | Counselor | 205 N College Avenue, Suite 210a, Bloomington, IN 47404 | 2020-07-29 |
| 1750926085 | Michelle Christine Dustin | Nurse Practitioner | 610 N Morton Street, Bloomigton, IN 47404 | 2019-11-11 |
| 1316440191 | Julie D'argent | Psychologist | 205 N College Ave Ste 430, Bloomington, IN 47404 | 2018-03-17 |
| 1770966467 | Richard Lawson | Counselor | 1117 North Jackson Street, Bloomington, IN 47404 | 2015-06-30 |
| 1477952109 | Teresa R. Foster | Social Worker | 205 N. College Avenue, Suite 210b, Bloomington, IN 47404 | 2014-08-19 |
| 1073879532 | First Health Plus, Inc | Clinic/Center | 104 North Curry Pike, Bloomington, IN 47404 | 2012-04-09 |
| 1497079982 | Tera Dee Nance | Counselor | 101 W. Kirkwood Avenue, Suite 009 Fountain Square Mall, Bloomington, IN 47404 | 2010-03-26 |
| 1962643114 | Pathways Counseling Center | Community/Behavioral Health | 3866 W. Third Street, Bloomington, IN 47404 | 2009-03-18 |
| 1932358595 | Catherine Elizabeth Batka | Psychologist | 101 W. Kirkwood Ave, Suite 103, Bloomington, IN 47404 | 2008-09-18 |
| 1396901005 | Kijin Woo | Dentist | 330 N Jacob Drive, Bloomington, IN 47404 | 2008-08-01 |
| Find all providers in zip 47404 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255857926 | Kare Clinic | Internal Medicine | 1696 W Hennessey St, Bloomington, IN 47403-4645 | 2017-08-15 |
| 1669756060 | Dhanasarn Mongkolsmai | Internal Medicine | 2206 Berrywood Ln, Bloomington, IL 61704-2448 | 2011-10-04 |
| 1982906566 | Guy H Waldo | Internal Medicine | 9133 S Front Nine Drive, Bloomington, IN 47401-8151 | 2010-12-02 |
| 1154556843 | Primary Care Specialists, LLC | Internal Medicine | 2 Airline Dr, Suite 500, Bloomington, IL 61704-3433 | 2009-05-25 |
| 1790922201 | John Leeper Mcnay Jr. | Internal Medicine | 2032 S. Ramsey Dr., Bloomington, IN 47401-7153 | 2009-01-21 |
| 1790947539 | Jared A Frazin | Internal Medicine | 9332 Rich Rd, Bloomington, MN 55437-2074 | 2008-07-01 |
| 1114124575 | Joseph Michael Mackey | Internal Medicine | 1011 West Second Street, Bloomington, IN 47403-2216 | 2007-06-29 |
| 1588867386 | Virgil D. Short | Internal Medicine | 326 Fairway Dr, Bloomington, IL 61701-3462 | 2007-06-08 |
| 1013086792 | Daniel R Berg Md PC | Internal Medicine | 2620 North Walnut Street, Suite 400, Bloomington, IN 47404 | 2006-11-07 |
| 1386736023 | Jerry Antonini | Internal Medicine | 1505 Eastland Drive, Suite 320, Bloomington, IL 61701-3534 | 2006-09-29 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 47404 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.