Carly Ann Hendricks, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0035261 Issued in OH

Practice address

3333 Burnet Ave, ML 11027
Cincinnati, OH 45229-3026

Phone

(513) 517-2234

Fax

(513) 803-1969

NPI assigned

Oct 25, 2021

Sex

Female

Sole proprietor

Yes

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 OH

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.

• Children'S Hospital Medical Center

  • Pediatrics Physician
  • Cincinnati, OH
  • NPI 1609915784

  Nurse Practitioner

  Medicare reassignment NPD
• Cincinnati Children'S Hospital Medical Center

  • Student in an Organized Health Care Education/Training Program
  • Cincinnati, OH
  • NPI 1669195418
  NPD

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1497419626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "553-636-4432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE, ML 11027",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-517-2234",
            "fax_number": "513-803-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "CARLY",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "0035261",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "529290",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruby Marie Henderson
• Veronica Henderson, NP-C
• Xenia Hendley
• Alexandria Maxine Hendon
• Frances R Hendrick, P.C.C.
• Charles Michael Hendricks, M.D.
• Chase M Hendricks
• Jack Allen Hendricks
• Matthew Hendricks
• Michael Kyler Hendricks, ATC

• Nurse Practitioner in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.