Individual provider Active NPI

Lorna J Hendricks, PT

  • Physical Therapist
  • Fenton, MI
National Provider Identifier
1710107875
Registry record updated Sep 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501010219 Issued in MI
Practice address
425 Fenway Drive
Suite a
Fenton, MI 48430
Phone
(810) 750-5444
Fax
(810) 750-5440
NPI assigned
Apr 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501010219 MI Primary

Addresses

Primary practice location

425 Fenway Drive
Suite a
Fenton, MI 48430

Mailing address

3495 S Center Rd
Burton, MI 48519-1455
Phone (810) 424-2007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070816000296 MI Practitioner - Physical Therapist in Private Practice 6709978018 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Medical Group GenesysGroup PAC ID 7214288281, 96 clinicians

Practice addresses (Care Compare)

1096 S Belsay Rd
Suite G
Burton, MI 48509-1948
Phone (810) 743-1611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Medical Group Genesys Physical Therapist CurrentSince Jan 1, 2019 Accepting new patients
Henry Ford Medical Group Genesys Current Accepting new patients
Boike Medical Services PLLC Past Accepting new patients
Stephen Harrison DO PC PastSince Nov 14, 2011 Accepting new patients
Genesys Regional Medical Center Physical Therapist Past Accepting new patients

Locations

425 N Fenway Dr
Ste A
Fenton, MI 48430
Phone (810) 750-5444

1096 S Belsay Rd
Ste G
Flint, MI 48509
Phone (810) 743-1611

3495 S Center Rd
Flint, MI 48519
Phone (810) 424-2025

2184 S Ballenger Hwy
Flint, MI 48503
Phone (810) 232-5627

10785 S Saginaw St
Ste D
Grand Blanc, MI 48439
Phone (810) 695-6337

8447 Holly Rd
Ste C
Grand Blanc, MI 48439
Phone (810) 695-9268

7057 N Clio Rd
Mount Morris, MI 48458
Phone (810) 564-2555

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190851200000",
    "number": "1710107875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191455",
            "telephone_number": "810-424-2007",
            "fax_number": "810-743-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 FENWAY DRIVE",
            "address_2": "SUITE A",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "48430",
            "telephone_number": "810-750-5444",
            "fax_number": "810-750-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "LORNA",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-30",
        "last_updated": "2007-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.