Individual provider Active NPI

Angie Hendrix

  • Specialist
  • Nampa, ID
National Provider Identifier
1083073902
Registry record updated Feb 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
823 Parkcentre Way
Nampa, ID 83651-1783
Phone
(208) 573-0968
Fax
(208) 463-0972
NPI assigned
Feb 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

823 Parkcentre Way
Nampa, ID 83651-1783

Mailing address

823 Parkcentre Way
Nampa, ID 83651-1783
Phone (208) 573-0968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1455840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455840000000",
    "number": "1083073902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 PARKCENTRE WAY",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836511783",
            "telephone_number": "208-573-0968",
            "fax_number": "208-463-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 PARKCENTRE WAY",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836511783",
            "telephone_number": "208-573-0968",
            "fax_number": "208-463-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "ANGIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-19",
        "last_updated": "2016-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; 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.