Organization Active NPI

Hendrick Wellness Center, P.C.

  • Family Nurse Practitioner
  • McAllen, TX
National Provider Identifier
1053747402
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
796415 Issued in TX
Legal business name
HENDRICK WELLNESS CENTER, P.C.
Practice address
5403 N McColl Rd
Suite a
McAllen, TX 78504-2206
Phone
(956) 630-2255
Fax
(956) 630-5228
NPI assigned
Sep 17, 2013
Last updated
Jan 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Authorized official

Name
Blaine Hendrick, FNP-CNPI 1750330445
Title
Owner/Family Nurse Practitioner
Phone
(956) 630-2255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 796415 TX Primary

Addresses

Primary practice location

5403 N McColl Rd
Suite a
McAllen, TX 78504-2206

Mailing address

5403 N McColl Rd
Suite a
McAllen, TX 78504-2206
Phone (956) 630-2255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131230001175 TX Part B Supplier - Clinic/Group Practice 0840427506 Receives reassigned benefits from 2 practitioners
Practice locations: McAllen, TX

National Provider Directory

National Provider Directory

Locations

5403 N McColl Rd
Ste A
McAllen, TX 78504
Phone (956) 630-2255

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390348800000",
    "number": "1053747402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5403 N MCCOLL RD",
            "address_2": "SUITE A",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785042206",
            "telephone_number": "956-630-2255",
            "fax_number": "956-630-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5403 N MCCOLL RD",
            "address_2": "SUITE A",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785042206",
            "telephone_number": "956-630-2255",
            "fax_number": "956-630-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDRICK WELLNESS CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-17",
        "last_updated": "2014-01-22",
        "status": "A",
        "authorized_official_last_name": "HENDRICK",
        "authorized_official_first_name": "BLAINE",
        "authorized_official_title_or_position": "OWNER/FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "956-630-2255",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "796415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.