Active NPI
Melissa Ann Hendricks, RD
- Registered Dietitian
- State College, PA
National Provider Identifier
1265717524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN004290
- Practice address
- 200 Scenery Dr
State College, PA 16801-7974 - Phone
- (814) 231-4560
- Fax
- (814) 231-6246
- NPI assigned
- Oct 19, 2011
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DN004290 | PA | Primary |
Addresses
Primary practice location
200 Scenery Dr
State College, PA 16801-7974
Mailing address
100 N Academy Ave
Credentials Dept
Danville, PA 17822-4903
Phone (570) 271-6144
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": "1318982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318982400000",
"number": "1265717524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"address_2": "CREDENTIALS DEPT",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178224903",
"telephone_number": "570-271-6144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 SCENERY DR",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168017974",
"telephone_number": "814-231-4560",
"fax_number": "814-231-6246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICKS",
"first_name": "MELISSA",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-19",
"last_updated": "2011-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN004290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in State College, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.