Kelsi Marie Hendrickson

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4015202 Issued in KY

Practice address

1 Trillium Way
Corbin, KY 40701-8426

Phone

(606) 528-1212

NPI assigned

Dec 12, 2023

Last updated

Jan 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Kentucky Em-I Medical Services PSCGroup PAC ID 8325001175, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kentucky Em-I Medical Services PSC

  • Emergency Medicine Physician
  • Ashland, KY
  • NPI 1356848121

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Kentucky Em-I Medical Services PSC

  • Emergency Medicine Physician
  • Murray, KY
  • NPI 1740512615

  Nurse Practitioner

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1043088792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TRILLIUM WAY",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TRILLIUM WAY",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018426",
            "telephone_number": "606-528-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "KELSI",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-12",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4015202",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1162589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip E Henderlight Jr., DMD
• Angel Henderson, APRN
• Henrietta Hendrickson, RN
• Juanita Hendrickson
• Kayla Hendrickson, APRN
• Amber Nicole Hensley, BS
• Brenda Jean Hensley
• Elizabeth Ann Hensley, BSW
• Cody Henson
• Kristin Henson

• Nurse Practitioner in Corbin, KY
• Providers in Corbin, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.