Jerry Lucas Hendrix, P.T.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT0000007480 Issued in TN

Practice address

258 Dale Haven LN
Tullahoma, TN 37388-8006

Phone

(931) 581-8390

NPI assigned

Oct 4, 2005

Last updated

Jul 8, 2014By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1689661662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 DALE HAVEN LN",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373888006",
            "telephone_number": "931-581-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 DALE HAVEN LN",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373888006",
            "telephone_number": "931-581-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "JERRY",
        "middle_name": "LUCAS",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "17409",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TN",
            "license": "PT0000007480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lydia Marie Harvey
• Allison Anne Hastings, LMSW
• Lisa A. Hatfield, PT
• Carrie Hawk, BS
• Hearwell, LLC
• Ola Merle Henson, CFNP
• Henson's Family Medical LLC
• Jessica Hice
• Kellie Hickerson, B.S.W.
• Kay Watson Hickey, M.A.

• Physical Therapy Clinic/Center in Tullahoma, TN
• Providers in Tullahoma, TN by specialty
• Physical Therapy Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; 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.