Individual provider Active NPI

Alexander Hendricks, PHARMD

  • Pharmacist
  • Tahlequah, OK
National Provider Identifier
1215337001
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15747 Issued in OK
Practice address
100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone
(918) 458-3105
NPI assigned
Aug 28, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15747 OK Primary

Addresses

Primary practice location

100 S Bliss Ave
Tahlequah, OK 74464-2512

Mailing address

405 Minor St
Tahlequah, OK 74464-6813
Phone (918) 207-7331

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
15747OKMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409184000000",
    "number": "1215337001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 MINOR ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744646813",
            "telephone_number": "918-207-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S BLISS AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744642512",
            "telephone_number": "918-458-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "ALEXANDER",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-28",
        "last_updated": "2014-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "15747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; 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.