Todd R Hendrickson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

26800 Issued in WI

Practice address

110 E 5TH Ave
Antigo, WI 54409-2710

Phone

(715) 623-2351

NPI assigned

Jul 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Aspirus Medical Group, Inc.

  • Clinic/Center
  • Wausau, WI
  • NPI 1144272089
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508884834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 WESTHILL DR",
            "address_2": "SUITE 303",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E 5TH AVE",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092710",
            "telephone_number": "715-623-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "TODD",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "26800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30657300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Nicole Hauser, PHARMD
• Hearing Advantage LLC
• Hearing Services
• Gary M Hegranes, MD
• Kendall Lynn Held, M.S
• Debra J Henke
• Bonnie J Hessedal, RD
• Charles A Heuss, M.D.
• Stephanie Marie Hilgart, SAC-IT
• Jesse Daniel Hoffmeister, M.S., SLP

• Surgery Physician in Antigo, WI
• Providers in Antigo, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.