Active NPI
Christy Hendrickson, OTR
- Occupational Therapist
- Ringgold, GA
National Provider Identifier
1184775322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT003643
- Practice address
- 267 Carriage Dr
Ringgold, GA 30736-6204 - Phone
- (865) 851-4201
- NPI assigned
- Jan 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT003643 | GA | Primary |
| Occupational Therapist | 225X00000X | 3974 | TN |
Addresses
Primary practice location
267 Carriage Dr
Ringgold, GA 30736-6204
Mailing address
267 Carriage Dr
Ringgold, GA 30736-6204
Phone (865) 851-4201
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000964301A | Medicaid | GA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT003643 | GA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305244800000",
"number": "1184775322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "267 CARRIAGE DR",
"city": "RINGGOLD",
"state": "GA",
"postal_code": "307366204",
"telephone_number": "865-851-4201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "267 CARRIAGE DR",
"city": "RINGGOLD",
"state": "GA",
"postal_code": "307366204",
"telephone_number": "865-851-4201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICKSON",
"first_name": "CHRISTY",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-15",
"last_updated": "2011-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT003643",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TN",
"license": "3974",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000964301A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ringgold, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.