Amanda Hendricks, Aprn, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

AMANDA HENDRICKS, APRN, PLLC

Practice address

1230 Woodland Dr Ste 211
Elizabethtown, KY 42701-2792

Phone

(270) 982-2500

Fax

(270) 982-2501

NPI assigned

Nov 2, 2022

Last updated

May 3, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Amanda Sue Hendricks, APRNNPI 1679867014

Title

Owner

Phone

(270) 307-3905

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda Sue Hendricks, APRN

  • Family Nurse Practitioner
  • Elizabethtown, KY
  • NPI 1679867014
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683072000000",
    "number": "1396452934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 WOODLAND DR STE 211",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012792",
            "telephone_number": "270-982-2500",
            "fax_number": "270-982-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 WOODLAND DR STE 211",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012792",
            "telephone_number": "270-982-2500",
            "fax_number": "270-982-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDA HENDRICKS, APRN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-02",
        "last_updated": "2023-05-03",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-307-3905",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Primary Care Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.