Active NPI
Jack GG Hendershot Jr., MD
- Ophthalmology Physician
- Findlay, OH
National Provider Identifier
1255332987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 37324
- Practice address
- 15840 Medical Drive South
Suite a
Findlay, OH 45840 - Phone
- (419) 422-6190
- Fax
- (419) 423-3235
- NPI assigned
- Aug 3, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 37324 | OH | Primary |
Addresses
Primary practice location
15840 Medical Drive South
Suite a
Findlay, OH 45840
Mailing address
15840 Medical Drive South
Suite a
Findlay, OH 45840
Phone (419) 422-6190
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0277276 | Medicaid | OH | |
| 000000129596 | Other | OH | ANTHEM BCBS |
| 4281257 | Other | OH | AETNA |
| 037324 | Other | OH | STATE LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37324 | OH | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Findlay Surgery Center LTD | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Ambulatory Surgical Clinic/Center
- Findlay, OH
- NPI 1780610576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1255332987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15840 MEDICAL DRIVE SOUTH",
"address_2": "SUITE A",
"city": "FINDLAY",
"state": "OH",
"postal_code": "45840",
"telephone_number": "419-422-6190",
"fax_number": "419-423-3235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15840 MEDICAL DRIVE SOUTH",
"address_2": "SUITE A",
"city": "FINDLAY",
"state": "OH",
"postal_code": "45840",
"telephone_number": "419-422-6190",
"fax_number": "419-423-3235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSHOT",
"first_name": "JACK",
"middle_name": "GG",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-03",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "OH",
"license": "37324",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0277276",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000129596",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4281257",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "037324",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Findlay, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.