Active NPI
Larry Keith Henrickson, PH.D.
- Audiologist
- Ruston, LA
National Provider Identifier
1356466361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 5708
- Practice address
- La Tech University Speech Hearing Ctr
Robinson Hall - Room 218
Ruston, LA 71272-0001 - Phone
- (318) 257-4764
- Fax
- (318) 257-4492
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 5708 | LA | Primary |
Addresses
Primary practice location
La Tech University Speech Hearing Ctr
Robinson Hall - Room 218
Ruston, LA 71272-0001
Mailing address
117 N Pinecrest Dr
Ruston, LA 71270-2859
Phone (318) 251-9231
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5708 | LA | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356466361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 N PINECREST DR",
"city": "RUSTON",
"state": "LA",
"postal_code": "712702859",
"telephone_number": "318-251-9231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "LA TECH UNIVERSITY SPEECH HEARING CTR",
"address_2": "ROBINSON HALL - ROOM 218",
"city": "RUSTON",
"state": "LA",
"postal_code": "712720001",
"telephone_number": "318-257-4764",
"fax_number": "318-257-4492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRICKSON",
"first_name": "LARRY",
"middle_name": "KEITH",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "LA",
"license": "5708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ruston, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.