Organization Active NPI

Hendrick Provider Network

  • Internal Medicine Physician
  • Abilene, TX
National Provider Identifier
1396961322
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HENDRICK PROVIDER NETWORK
Practice address
1904 Pine St
Suite 200
Abilene, TX 79601-2344
Phone
(325) 670-4220
NPI assigned
Apr 18, 2007
Last updated
Mar 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2013

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

Authorized official

Name
Joe Pearson
Title
VP Regional Services
Phone
(325) 670-7106

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X
Hematology & Oncology Physician 207RH0003X
Interventional Cardiology Physician 207RI0011X
Rheumatology Physician 207RR0500X
Obstetrics & Gynecology Physician 207V00000X
Ophthalmology Physician 207W00000X
Neurology Physician 2084N0400X
Surgery Physician 208600000X
Sleep Medicine (Internal Medicine) Physician 207RS0012X
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X

Addresses

Primary practice location

1904 Pine St
Suite 200
Abilene, TX 79601-2344

Mailing address

PO Box 1198
Abilene, TX 79604-1198
Phone (325) 670-4220

Other identifiers 2

IdentifierTypeStateIssuer
080866901MedicaidTX
0060AEOtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040609001047 TX Part B Supplier - Clinic/Group Practice 9739162181 Receives reassigned benefits from 449 practitioners

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1090438Hendrick Provider Network1904 Pine Street Suite 3a, Abilene, TX 79601Certificate of waiverOct 9, 2026

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

1201 N 18th St
Abilene, TX 79601
Phone (325) 793-3300

1233 N 18th St
Abilene, TX 79601
Phone (325) 437-3687

1680 Antilley Rd
Ste 125
Abilene, TX 79606
Phone (325) 428-5580

1680 Antilley Rd
Ste 321
Abilene, TX 79606
Phone (325) 437-1590

1750 Pine St
Abilene, TX 79601
Phone (325) 670-0500

1750 Pine St
Ste 100
Abilene, TX 79601
Phone (325) 670-3636

1904 Pine St
Ste 3A
Abilene, TX 79601
Phone (325) 670-6180

1924 Pine St
Ste 501
Abilene, TX 79601
Phone (325) 670-4333

6200 Regional Plz
Ste 1675
Abilene, TX 79606
Phone (325) 670-2255

6250 Regional Plz
Ste 1000
Abilene, TX 79606
Phone (325) 428-5520

6250 Regional Plz
Ste 1060
Abilene, TX 79606
Phone (325) 428-5500

103 S Park Dr
Ste B
Brownwood, TX 76801
Phone (325) 643-8080

125 S Park Dr
Ste D
Brownwood, TX 76801
Phone (325) 641-2500

300 E Commerce St
Brownwood, TX 76801
Phone (325) 510-3400

203 S Daugherty Ave
Eastland, TX 76448
Phone (254) 629-3200

1417 N 1st St
Haskell, TX 79521
Phone (940) 228-0612

Practitioners & affiliated clinicians

Practitioners 487

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.

View all 487

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363046400000",
    "number": "1396961322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1198",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796041198",
            "telephone_number": "325-670-4220",
            "fax_number": "325-672-8292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 PINE ST",
            "address_2": "SUITE 200",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012344",
            "telephone_number": "325-670-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDRICK PROVIDER NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2013-03-12",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "VP REGIONAL SERVICES",
        "authorized_official_telephone_number": "325-670-7106"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080866901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0060AE",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.