John Everett Hendricks Jr., PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10001247A/B Issued in IN

Practice address

5411 W 78TH St
Johns Hopkins University/Pepsico Health & Wellness Ctr
Indianapolis, IN 46268-4150

Phone

(317) 876-6928

Fax

(317) 876-6931

NPI assigned

Jan 24, 2007

Last updated

Dec 10, 2012By the provider in NPPES

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355097600000",
    "number": "1154476976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 W 78TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462684150",
            "telephone_number": "317-876-6928",
            "fax_number": "317-876-6931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5411 W 78TH ST",
            "address_2": "JOHNS HOPKINS UNIVERSITY/PEPSICO HEALTH & WELLNESS CTR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462684150",
            "telephone_number": "317-876-6928",
            "fax_number": "317-876-6931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "JOHN",
        "middle_name": "EVERETT",
        "name_suffix": "Jr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2012-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001247A/B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hendricks County Hospital (Brickyard Healthcare - Brookview Care Center)
• Hendricks County Hospital
• Hendricks County Hospital (Brickyard Healthcare - Willow Springs Care Center)
• Brody Hendricks
• Carol Denise Hendricks, MSW
• Abigail Hendrickson, PA
• Holly M Hendrickson, MD
• Lexie Marie Hendrickson
• Bryan E Hendrix, DPM
• Marcus Hendry, MD

• Physician Assistant in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2012; 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.