Individual provider Active NPI

Laurain C. Hendricks, M.D.

  • Family Medicine Physician
  • Sedalia, MO
National Provider Identifier
1326159245
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2004001454 Issued in MO
Practice address
305 W Main St
Sedalia, MO 65301-3821
Phone
(660) 310-0909
NPI assigned
Aug 31, 2006
Last updated
Sep 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2004001454 MO Primary

Addresses

Primary practice location

305 W Main St
Sedalia, MO 65301-3821

Mailing address

821 Westwood Dr
Sedalia, MO 65301-2102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040910000014 MO Practitioner - Family Practice 0345216321 Reassigns benefits to 2 organizations
I20110212000073 IL Practitioner - Family PracticePractitioner - Emergency Medicine 0345216321 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2004001454MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Family Medicine CurrentSince Dec 1, 2019 Accepting new patients
Vpa PC Family Medicine CurrentSince Dec 1, 2019 Accepting new patients
Vpa PC Family Medicine CurrentSince Dec 1, 2019 Accepting new patients
Total Access Urgent Care, PC Family Medicine CurrentSince Sep 4, 2024 Accepting new patients
Total Access Urgent Care, PC General Practice CurrentSince Sep 4, 2024 Accepting new patients
Physician Groups LC Family Medicine Past Accepting new patients
Specialty Physicians of Illinois, LLC PastSince Mar 5, 2023 Accepting new patients

Locations

1000 Burr Ridge Pkwy
Ste 201
Burr Ridge, IL 60527
Phone (312) 818-4650

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

8706 Manchester Rd
Ste 106
Saint Louis, MO 63144
Phone (314) 961-3570

8710 Manchester Rd
Saint Louis, MO 63144
Phone (314) 961-3570

9556 Manchester Rd
Saint Louis, MO 63119
Phone (314) 373-5740

1717 Madison Ave
Washington, MO 63090
Phone (636) 244-6950

13861 Manchester Rd
Wildwood, MO 63011
Phone (636) 220-9333

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1326159245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 WESTWOOD DR",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W MAIN ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653013821",
            "telephone_number": "660-310-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "LAURAIN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2004001454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedalia, MO

Sources for this page

Verify at the official NPI Registry.