Mary Catherine Hendren, NP
Individual provider Active NPI Family Nurse Practitioner · Dayton, TN
NPI 1063644656 · NPPES record last updated Aug 14, 2009
Key facts
- NPI
- 1063644656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APN0000014168 (TN)
- Practice address
- 188 16TH Ave Ste 106
Dayton, TN 37321-1037 - Phone
- (423) 775-1160
- Fax
- (423) 775-1767
- NPI assigned
- Aug 14, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091111000123 | TN | Practitioner - Nurse Practitioner | 3577601608 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN0000014168 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ocoee Regional Health Corporation | Current |
Accepting new patients | |
| Ocoee Regional Health Corporation | Current | Accepting new patients | |
| Ocoee Regional Health Corporation | Current |
Accepting new patients |
Locations
188 16th Ave
Ste 106
Dayton, TN 37321
Phone (423) 775-1160
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APN0000014168 | TN | Yes |
Addresses
Primary practice location
188 16TH Ave Ste 106
Dayton, TN 37321-1037
Mailing address
188 16TH Ave Ste 106
Dayton, TN 37321-1037
Phone (423) 775-1160
Other providers in Dayton, TN
- Harris Hometown Dentistry PLLC
- Lauren Elaine Harris
- Robert W Harrison
- Healthforce of Dayton, Inc
- Zoa Henderson
- Paul Meredith Hendricks
- Timothy J Henry
- Rodney Lynn Herra Jr.
- Charles Lynn Hester II
- Claire Williams Higginbotham
All providers in Dayton, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.