Active NPI
Paul R Hendrycy, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Fayetteville, AR
National Provider Identifier
1003889064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- N7607
- Practice address
- 390 E Longview St
Fayetteville, AR 72703-4618 - Phone
- (479) 442-0144
- Fax
- (479) 442-4557
- NPI assigned
- Feb 9, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | N7607 | AR | Primary |
Addresses
Primary practice location
390 E Longview St
Fayetteville, AR 72703-4618
Mailing address
390 E Longview St
Fayetteville, AR 72703-4618
Phone (479) 442-0144
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| N7607 | Other | AR | AR LICENSURE |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N7607 | AR | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003889064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 E LONGVIEW ST",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034618",
"telephone_number": "479-442-0144",
"fax_number": "479-442-4557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "390 E LONGVIEW ST",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034618",
"telephone_number": "479-442-0144",
"fax_number": "479-442-4557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRYCY",
"first_name": "PAUL",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "AR",
"license": "N7607",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AR LICENSURE",
"identifier": "N7607",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.