Renee Hendrick, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

4704149226 Issued in MI

Practice address

900 E Michigan Ave
Jackson, MI 49201-2457

Phone

(517) 788-7866

NPI assigned

Aug 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MI

  Medicare reassignment NPD
• Kidney and Hypertension Specialists PLLC

  • Specialist
  • Jackson, MI
  • NPI 1174649354
  NPD (past)

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

{
    "created_epoch": "1344643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393632000000",
    "number": "1295082030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012457",
            "telephone_number": "517-788-7866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012457",
            "telephone_number": "517-788-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICK",
        "first_name": "RENEE",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-11",
        "last_updated": "2014-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704149226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared Hendershot
• Aisha Henderson
• Anthony David Henderson
• Kamryn Kay Henderson
• Cathleen Hendrick
• Theresa Louise Hendrick, RN
• Jessica Hendricks, LMSW
• Chandra Hendrickson
• Henry Ford Allegiance Pharmacy
• Ivy Henry

• Adult Health Nurse Practitioner in Jackson, MI
• Providers in Jackson, MI by specialty
• Adult Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.