Individual provider Active NPI

Jennifer M Hendrick, MD

  • Internal Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1144256728
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
38004 Issued in CO
Practice address
4674 Snow Mesa Dr
Suite 100
Fort Collins, CO 80528-8615
Phone
(970) 482-3712
Fax
(970) 482-4057
NPI assigned
Jun 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 38004 CO Primary

Addresses

Primary practice location

4674 Snow Mesa Dr
Suite 100
Fort Collins, CO 80528-8615

Mailing address

4674 Snow Mesa Dr
Suite 100
Fort Collins, CO 80528-8615
Phone (970) 482-3712

Other identifiers 3

IdentifierTypeStateIssuer
117633100MedicaidWY
P00970384OtherCORAILROAD MEDICARE
67439705MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041220000301 CO Practitioner - Internal Medicine 1254398498 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

1190 US Hwy 287
Broomfield, CO 80020-7021
Phone (303) 544-3800

1925 Mountain View Ave
Longmont, CO 80501-3128
Phone (303) 776-1234

206 W County Line Rd
Suite 300 Uchealth Medical Group
Highlands Ranch, CO 80129-2321
Phone (303) 795-5980

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

4674 Snow Mesa Dr
Suite 200
Fort Collins, CO 80528-8614
Phone (970) 495-8450

730 14TH St SW
Suite 200
Loveland, CO 80537-6349
Phone (970) 663-0815

Hospital & facility affiliations

  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119
  • Uchealth Greeley Hospital Hospital, Greeley, CO, CCN 060131
  • Longs Peak Hospital Hospital, Longmont, CO, CCN 060128

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38004COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Feb 13, 2011 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Feb 13, 2011 Accepting new patients
Poudre Valley Health Care Inc CurrentSince Nov 1, 2002 Accepting new patients
Poudre Valley Health Care Inc. CurrentSince Nov 1, 2002 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

2121 E Harmony Rd
Unit 330
Fort Collins, CO 80528
Phone (970) 221-5878

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

1025 Pennock Pl
Fort Collins, CO 80524
Phone (970) 495-8800

1025 Pennock Pl
#107
Fort Collins, CO 80524
Phone (970) 482-3712

4674 Snow Mesa Dr
Ste 100
Fort Collins, CO 80528
Phone (970) 482-3712

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 4

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.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422403200000",
    "number": "1144256728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4674 SNOW MESA DR",
            "address_2": "SUITE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288615",
            "telephone_number": "970-482-3712",
            "fax_number": "970-266-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4674 SNOW MESA DR",
            "address_2": "SUITE 100",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805288615",
            "telephone_number": "970-482-3712",
            "fax_number": "970-482-4057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICK",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2015-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "38004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117633100",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00970384",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "67439705",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.