Matthew Gerard Hendrickson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2059-19 Issued in WI

Practice address

10150 W National Ave
Suite 150
Milwaukee, WI 53227-2145

Phone

(800) 439-7012

Fax

(800) 882-0886

NPI assigned

Aug 23, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1083048243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2914 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535483297",
            "telephone_number": "608-757-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 W NATIONAL AVE",
            "address_2": "SUITE 150",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532272145",
            "telephone_number": "800-439-7012",
            "fax_number": "800-882-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "MATTHEW",
        "middle_name": "GERARD",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-23",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2059-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kahla Hendricks
• Laura Hendricks
• Virginia Hendricks, LPN
• Delaney Hendrickson
• Mary L Hendrickson, RPH,MBA
• Melissa M Hendrickson, NP
• Nolan Robert Hendrickson
• Jin Ying Heng
• Timothy Henke, DPM
• Tedan Hu Henkel

• Physical Therapy Assistant in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.