Carmen Hendricks

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

License

1234 Issued in NJ

Practice address

60 Roosevelt Ave Apt 3106
Carteret, NJ 07008-2487

Phone

(757) 966-8668

NPI assigned

Jun 27, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1154053437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 ROOSEVELT AVE APT 3106",
            "city": "CARTERET",
            "state": "NJ",
            "postal_code": "070082487",
            "telephone_number": "757-966-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 ROOSEVELT AVE APT 3106",
            "city": "CARTERET",
            "state": "NJ",
            "postal_code": "070082487",
            "telephone_number": "757-966-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "CARMEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Phlebology",
            "state": "NJ",
            "license": "1234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "carmenfuentes1177@gmail.com",
            "affiliation": "N",
            "endpointDescription": "the office",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Carteret",
            "address_1": "60 Roosevelt Ave Apt 3106",
            "city": "Carteret",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070082487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Phlebology Physician in Carteret, NJ
• Providers in Carteret, NJ by specialty
• Phlebology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.