Active NPI
Shanai Petrakos Hendrick, APRN
- Family Nurse Practitioner
- Louisville, KY
National Provider Identifier
1255767208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 3008164
- Practice address
- 220 Abraham Flexner Way Ste 1200
Louisville, KY 40202 - Phone
- (502) 584-3377
- Fax
- (502) 584-3480
- NPI assigned
- Sep 23, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3008164 | KY | Primary |
Addresses
Primary practice location
220 Abraham Flexner Way Ste 1200
Louisville, KY 40202
Mailing address
PO Box 909
Louisville, KY 40201-0909
Phone (502) 584-3377
Other practice location 1
1435 Cincinnati St
Dayton, OH 45417-4614
Phone (937) 449-0080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100400010 | Medicaid | KY |
Other names 1
- Shanai Marie Petrakos
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
220 Abraham Flexner Way
Suite 1100
Louisville, KY 40202-3826
Phone (502) 584-3377
Hospital & facility affiliations
- Norton Hospitals, Inc
- University of Louisville Hospital
- UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 78.96 of 100
- Quality
- 56.12
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.73
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Louisville Physicians, Inc. | Current | Accepting new patients | |
| University of Louisville Physicians, Inc. | Current | Accepting new patients |
Locations
7752 Solution Ctr
Chicago, IL 60677
220 Abraham Flexner Way
Ste 1200
Louisville, KY 40202
Phone (502) 584-3377
220 Abraham Flexner Way
Ste 1100
Louisville, KY 40202
Phone (502) 584-3377
571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700
220 Abraham Flexner Way
#1200
Louisville, KY 40202
Phone (502) 584-3377
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Louisville, KY
- NPI 1366722316
-
- Diagnostic Radiology Physician
- Louisville, KY
- NPI 1316294127
Hospital & facility affiliations 37
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1043348808
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1447388335
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1699514463
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1831195908
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1891799227
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548460800000",
"number": "1255767208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 909",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402010909",
"telephone_number": "502-584-3377",
"fax_number": "502-584-3480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 ABRAHAM FLEXNER WAY STE 1200",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "40202",
"telephone_number": "502-584-3377",
"fax_number": "502-584-3480"
}
],
"practiceLocations": [
{
"address_1": "1435 Cincinnati St",
"address_purpose": "LOCATION",
"city": "Dayton",
"state": "OH",
"postal_code": "454174614",
"country_code": "US",
"telephone_number": "937-449-0080",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HENDRICK",
"first_name": "SHANAI",
"middle_name": "PETRAKOS",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-23",
"last_updated": "2019-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": "3008164",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100400010",
"state": "KY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SHANAI",
"last_name": "PETRAKOS",
"middle_name": "MARIE",
"credential": "RN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.