Active NPI
Nicolle Ann Hendrick, DPT
- Physical Therapist
- Boardman, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT012432
- Practice address
- 835 McKay CT Ste 100
Boardman, OH 44512-5786 - Phone
- (330) 965-3899
- Fax
- (330) 965-3839
- NPI assigned
- Aug 28, 2019
- Last updated
- Aug 28, 2019
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT012432 | OH | Primary |
Addresses
Primary practice location
835 McKay CT Ste 100
Boardman, OH 44512-5786
Mailing address
835 McKay CT Ste 100
Boardman, OH 44512-5786
Phone (330) 965-3899
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
835 McKay CT
Suite 100
Boardman, OH 44512-5786
Phone (330) 758-4399
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT012432 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health Physicians Youngstown, LLC | Current | Accepting new patients | |
| Mercy Health Physicians Youngstown Specialty Care LLC | Current | Accepting new patients | |
| Mercy Health Physicians Youngstown Specialty Care LLC | Current | Accepting new patients | |
| Mercy Health Physicians Youngstown LLC | Current | Accepting new patients |
Locations
107 Royal Birkdale Dr
Ste A
Columbiana, OH 44408
Phone (330) 482-9350
410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905
1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182
250 E Federal St
Fl 4
Youngstown, OH 44503
Phone (330) 884-7010
835 McKay Ct
Ste 100
Youngstown, OH 44512
Phone (330) 758-4399
Interoperability endpoints
- nhendrick37174@direct.bsmhealth.org
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
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- Youngstown, OH
- NPI 1649892225
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- Family Medicine Physician
- Youngstown, OH
- NPI 1154636066
-
dba Mercy Health - Boardman Orthopaedics
- Durable Medical Equipment & Medical Supplies
- Boardman, OH
- NPI 1750920245
-
- Durable Medical Equipment & Medical Supplies
- Boardman, OH
- NPI 1386316107
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566950400000",
"number": "1255989836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "835 MCKAY CT STE 100",
"city": "BOARDMAN",
"state": "OH",
"postal_code": "445125786",
"telephone_number": "330-965-3899",
"fax_number": "330-965-3839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 MCKAY CT STE 100",
"city": "BOARDMAN",
"state": "OH",
"postal_code": "445125786",
"telephone_number": "330-965-3899",
"fax_number": "330-965-3839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICK",
"first_name": "NICOLLE",
"middle_name": "ANN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-28",
"last_updated": "2019-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT012432",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boardman, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.