Edward Mack Hendricks, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

LG-0000616 Issued in DE

Practice address

1181 Paddock Rd
Smyrna, DE 19977-9679

Phone

(302) 653-9261

Fax

(302) 659-6887

NPI assigned

Nov 15, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

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

State licenses

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.

• Sun Behavioral Delaware, LLC

  dba SUN Behavioral Delaware

  • Psychiatric Hospital
  • Georgetown, DE
  • NPI 1891213179
  Medicare reassignment NPD

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1407190309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1181 PADDOCK RD",
            "city": "SMYRNA",
            "state": "DE",
            "postal_code": "199779679",
            "telephone_number": "302-653-9261",
            "fax_number": "302-659-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 PADDOCK RD",
            "city": "SMYRNA",
            "state": "DE",
            "postal_code": "199779679",
            "telephone_number": "302-653-9261",
            "fax_number": "302-659-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "EDWARD",
        "middle_name": "MACK",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0000616",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R159470",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Noel Hauss, PHARMD
• Madison Hayburn
• Laurianne Haynes, MD
• Mary Hazlett, R.N.
• Kayla Marie Heiser, NP
• Here 2 There Transportation
• Lynnett A Hershbell, FNP-C
• Shane Peter Hierlmaier, DC
• Zachary Higgins
• Katrina Valerie High

• Family Nurse Practitioner in Smyrna, DE
• Providers in Smyrna, DE by specialty
• Family Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.