Active NPI
Elizabeth Jane Hendricks, PAC
- Physician Assistant
- Fort Wayne, IN
National Provider Identifier
1659314524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10000483A
- Practice address
- 3717 Maplecrest Rd
Fort Wayne, IN 46815-8424 - Phone
- (260) 486-7334
- Fax
- (260) 486-6447
- NPI assigned
- Jun 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10000483A | IN | Primary |
Addresses
Primary practice location
3717 Maplecrest Rd
Fort Wayne, IN 46815-8424
Mailing address
3717 Maplecrest Rd
Fort Wayne, IN 46815-8424
Phone (260) 486-7334
Other names 1
- Ms. Elizabeth Jane McLaughlin
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10000483A | IN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Joseph Health System, LLC | Past | Accepting new patients | |
| Redimed Dekalb LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Physician
- Auburn, IN
- NPI 1669417457
-
- Medicare Defined Swing Bed Hospital Unit
- Fort Wayne, IN
- NPI 1538812946
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300147200000",
"number": "1659314524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3717 MAPLECREST RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468158424",
"telephone_number": "260-486-7334",
"fax_number": "260-486-6447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3717 MAPLECREST RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468158424",
"telephone_number": "260-486-7334",
"fax_number": "260-486-6447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICKS",
"first_name": "ELIZABETH",
"middle_name": "JANE",
"name_prefix": "Mrs.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-14",
"last_updated": "2011-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": "10000483A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "MCLAUGHLIN",
"middle_name": "JANE",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.