Jennifer D Hendricks, P.T.

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

018457-1 Issued in NY

Practice address

171 Intrepid LN
Syracuse, NY 13205-2548

Phone

(315) 437-4689

Fax

(315) 437-4698

NPI assigned

Nov 16, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Jennifer D Butera Former name

Medicare fee-for-service enrollment

Enrolled in VI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lindsy Wagner LLCGroup PAC ID 3476800574, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lindsy Wagner LLC

  • Clinical Social Worker
  • Christiansted, VI
  • NPI 1235402611
  Medicare reassignment Care Compare group NPD
• The Network for Children'S Speech, Occupational and Physical Therapy

  • Early Intervention Provider Agency
  • Syracuse, NY
  • NPI 1619113255
  NPD (past)

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

{
    "created_epoch": "1226793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1740434828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 26044",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "00824",
            "telephone_number": "315-437-4689",
            "fax_number": "315-437-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 INTREPID LN",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052548",
            "telephone_number": "315-437-4689",
            "fax_number": "315-437-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-16",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "018457-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BUTERA",
            "middle_name": "D",
            "prefix": "MS.",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Geoffrey Henderson
• Haley Henderson
• Henderson'S Drug Store, Inc.
• Maria Hendix
• Mark Galen Hendrick, RPH
• Nancy Hendrickson, LMSW
• Cassandra Gray Aster Hennelly, MD
• Janice L Hennessy
• Meara Henninger-McMahon, PHD
• Althea M Henry, PHD

• Pediatric Physical Therapist in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Pediatric Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; 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.