Individual provider Active NPI

Janice L. Hendryx

  • Clinical Social Worker
  • Bethany, OK
National Provider Identifier
1265673636
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4205 Issued in OK
Practice address
3908 N Peniel Ave
Suite 420
Bethany, OK 73008-3458
Phone
(405) 603-3265
Fax
(405) 603-6624
NPI assigned
Mar 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4205 OK Primary

Addresses

Primary practice location

3908 N Peniel Ave
Suite 420
Bethany, OK 73008-3458

Mailing address

7244 NW 129TH St
Oklahoma City, OK 73142-2544
Phone (405) 517-7612

Other identifiers 1

IdentifierTypeStateIssuer
200362380BMedicaidOK

Other names 1

  • Janice L. Thompson Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1265673636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7244 NW 129TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731422544",
            "telephone_number": "405-517-7612",
            "fax_number": "405-603-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3908 N PENIEL AVE",
            "address_2": "SUITE 420",
            "city": "BETHANY",
            "state": "OK",
            "postal_code": "730083458",
            "telephone_number": "405-603-3265",
            "fax_number": "405-603-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRYX",
        "first_name": "JANICE",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-16",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "4205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200362380B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANICE",
            "last_name": "THOMPSON",
            "middle_name": "L.",
            "credential": "M.S.W.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bethany, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.