MEDICARE: KEVIN HARDY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224P00000X	Prosthetist

General Provider Information

NPI Number	:	1124987839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN HARDY

Provider Business Mailing Address
First Line	:	10420 PARK RD STE 100A
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-8478
Country	:	US
Telephone Number	:	704-557-0700
Fax Number	:	704-307-2871

Provider Business Practice Location Address
First Line	:	10420 PARK RD STE 100A
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-8478
Country	:	US
Telephone Number	:	704-557-0700
Fax Number	:	704-307-2871

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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Directions to “ KEVIN HARDY ” Practice Location

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