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SHANE MICHEAL HARDEMON
NPI 1003634478
Peer Specialist in Blackwell, OK

Active since October 02, 2024
444 E COLLEGE AVE, BLACKWELL, OK 74631(580) 401-7527 Get Directions Write a Review

NPPES record last updated: October 2, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shane Micheal Hardemon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANE MICHEAL HARDEMON (NPI 1003634478) is an individual peer specialist in Blackwell, Oklahoma and active in the NPI registry since October 2024.

NPPES Registry Identity

NPI1003634478
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameSHANE MICHEAL HARDEMON
Location Address444 E COLLEGE AVEBlackwell, OK 74631-3319
Mailing Address444 E College AveBlackwell, OK 74631-3319 · (580) 401-7527
Phone(580) 401-7527
Sole ProprietorYes
Enumeration DateOctober 2, 2024
NPPES CertifiedOctober 2, 2024
✔ NPI 1003634478 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
444 E COLLEGE AVE, Blackwell, OK 74631
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Hardemon's NPI number?

The NPI number for Shane Hardemon is 1003634478. It was assigned to this individual provider in the NPPES registry on October 2, 2024.

Where is Shane Hardemon located?

Shane Hardemon practices at 444 E College Ave, Blackwell, OK 74631. The listed phone number is (580) 401-7527.

What is Shane Hardemon's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Shane Hardemon was last updated on October 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.