Gaylord Allan Hendricks

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

13789 Issued in FL

Practice address

716 NW 1St Ave
Boynton Beach, FL 33426-4304

Phone

(561) 541-3700

NPI assigned

Sep 7, 2023

Last updated

Aug 6, 2024By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Pride Tribe Inc.

  dba Connie House ALF

  • Assisted Living Facility
  • Boynton Beach, FL
  • NPI 1043040249
  NPD Authorized official

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1700662376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 NW 1ST AVE",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334264304",
            "telephone_number": "561-541-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 NW 1ST AVE",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334264304",
            "telephone_number": "561-541-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "GAYLORD",
        "middle_name": "ALLAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-07",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "13789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marianne Helmy
• Germena Hemai
• Hematology and Medical Oncology of Southern Palm Beach County Inc
• Hematology Oncology Associates of the Palm Beaches (Hematology Oncology Associates)
• Anna Hemlock, LMT
• Caron Henry, RN
• Francesca Henry
• Keisha Dwynette Henry, LCSW
• Robert Anthony Henry, PTA
• Makahala Hepburn, LCSW

• Assisted Living Facility in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.