Individual provider Active NPI

Rachel Lauren Hedrick, PSYD

  • Psychologist
  • San Antonio, TX
National Provider Identifier
1063996338
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
37086 Issued in TX
Practice address
1314 E Sonterra Blvd
Suite 2208
San Antonio, TX 78258
Phone
(210) 858-1900
Fax
(210) 745-4525
NPI assigned
Sep 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 37086 TX Primary

Addresses

Primary practice location

1314 E Sonterra Blvd
Suite 2208
San Antonio, TX 78258

Mailing address

4040 Broadway
Suite 518
San Antonio, TX 78209
Phone (210) 858-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181219003057 TX Practitioner - Clinical Psychologist 8921343930 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

611 Broadway St
San Antonio, TX 78215-1823
Phone (210) 802-8055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37086TXMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Restore Behavioral Health, PLLC CurrentSince Aug 16, 2018 Accepting new patients
Rachel Hedrick, PSYD, PLLC CurrentSince Jan 22, 2024 Accepting new patients

Locations

611 Broadway St
San Antonio, TX 78215
Phone (210) 802-8055

1314 E Sonterra Blvd
Ste 2208
San Antonio, TX 78258
Phone 2108581900 ext. 303

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9432/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1063996338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 BROADWAY",
            "address_2": "SUITE 518",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78209",
            "telephone_number": "210-858-1900",
            "fax_number": "210-745-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 E SONTERRA BLVD",
            "address_2": "SUITE 2208",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78258",
            "telephone_number": "210-858-1900",
            "fax_number": "210-745-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDRICK",
        "first_name": "RACHEL",
        "middle_name": "LAUREN",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-21",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "37086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.