Ebonique Hendricks, BS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3228 Issued in TN

Practice address

270 German Oak Dr
Cordova, TN 38018-7220

Phone

(901) 546-7660

Fax

(901) 546-7662

NPI assigned

May 17, 2007

Last updated

Jan 12, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ebonique Lovette Carney Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1720295520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7381 YONI LN",
            "city": "ARLINGTON",
            "state": "TN",
            "postal_code": "380025972",
            "telephone_number": "205-837-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 GERMAN OAK DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380187220",
            "telephone_number": "901-546-7660",
            "fax_number": "901-546-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "EBONIQUE",
        "credential": "BS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "3228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EBONIQUE",
            "last_name": "CARNEY",
            "middle_name": "LOVETTE",
            "credential": "BS, OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Hemphill, LCSW
• Marquinet C Hence, DDS
• Kendrick Knoll Henderson, MD
• Lori Yvette Henderson, FNP-C
• Tiara Henderson
• Barbara T Henking, PHD
• Henry Polk Dental Group, DPC
• Pauline Hensley, M.S., CCC-SLP
• Jennifer Henson, O.D
• Ami L Herbstrith, DPM

• Occupational Therapist in Cordova, TN
• Providers in Cordova, TN by specialty
• Occupational Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; 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.