Individual provider Active NPI

William B Hendrix, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bradenton, FL
National Provider Identifier
1407844988
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
ARNP1682212 Issued in FL
Practice address
5325 26TH St W
Bradenton, FL 34207
Phone
(941) 752-7173
NPI assigned
Oct 10, 2005
Last updated
Jun 4, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP1682212 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X ARNP1682212 FL Primary

Addresses

Primary practice location

5325 26TH St W
Bradenton, FL 34207

Mailing address

700 8TH Ave W Ste 101
Palmetto, FL 34221-4737
Phone (813) 657-3200

Other practice location 1

100 Main St
Ste 203
Safety Harbor, FL 34695-3668
Phone (727) 799-4150

Other practice location 2

100 Main St
Ste 203
Safety Harbor, FL 34695-3668
Phone (727) 799-4150

Other identifiers 1

IdentifierTypeStateIssuer
763969400MedicaidFL

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP1682212FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kolettis Krew LLC PastSince Apr 4, 2018 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: william.hendrix@metrotampabay.directbygreenway.com

Organizations & group practices 1

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1407844988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 8TH AVE W STE 101",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342214737",
            "telephone_number": "813-657-3200",
            "fax_number": "813-657-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 26TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34207",
            "telephone_number": "941-752-7173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 MAIN ST",
            "address_2": "STE 203",
            "address_purpose": "LOCATION",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346953668",
            "country_code": "US",
            "telephone_number": "727-799-4150",
            "fax_number": "727-796-1845",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 MAIN ST",
            "address_2": "STE 203",
            "address_purpose": "LOCATION",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346953668",
            "country_code": "US",
            "telephone_number": "727-799-4150",
            "fax_number": "727-796-1845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "WILLIAM",
        "middle_name": "B",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP1682212",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP1682212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "763969400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.