Sandra T Hendrickson

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

RN080911 Issued in GA

Practice address

604 Riverside Ave
Waycross, GA 31501-5323

Phone

(912) 287-4863

Fax

(912) 287-5875

NPI assigned

Oct 18, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

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.

• Bulloch County Board of Health

  dba Bulloch Wellness Center

  • Public Health or Welfare Agency
  • Statesboro, GA
  • NPI 1043243876
  Medicare reassignment NPD
• Coffee County Board of Health

  • Public Health or Welfare Agency
  • Douglas, GA
  • NPI 1952346074
  Medicare reassignment NPD
• Harrison C Carter MD PC

  • Specialist
  • Alma, GA
  • NPI 1619174091
  Medicare reassignment NPD
• Bulloch County Board of Health

  • Public Health or Welfare Agency
  • Statesboro, GA
  • NPI 1417985060
  NPD
• Coffee County Board of Health

  dba Coffee Wellness Center

  • Public Health or Welfare Agency
  • Douglas, GA
  • NPI 1316976699
  NPD
• Candler County Board of Health

  • Public Health or Welfare Agency
  • Metter, GA
  • NPI 1649208216
  NPD (past)

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1558646901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 CHURCH ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315013525",
            "telephone_number": "912-287-4863",
            "fax_number": "912-287-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 RIVERSIDE AVE",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015323",
            "telephone_number": "912-287-4863",
            "fax_number": "912-287-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "SANDRA",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-18",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN080911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helping Hands Behavioral Solutions
• Henderson Family Practice, Inc
• Jeannie Henderson
• Lori Henderson, NP-C
• Tiffany Henderson, LCSW
• Amy Hendrix-Bennett
• Fady Henein, MD
• Dorothy Rene Herdman, LCSW
• Allison Callaway Herrin, CCC-SLP
• Caroline Herrin

• Women's Health Nurse Practitioner in Waycross, GA
• Providers in Waycross, GA by specialty
• Women's Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; 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.