Kathryn Hendricks, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601007059 Issued in MI

Practice address

2700 Baker St FL 3
Muskegon, MI 49444-2157

Phone

(231) 737-1335

NPI assigned

Feb 17, 2015

Last updated

Mar 9, 2020By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hackley Community Care Center Inc

  • Federally Qualified Health Center (FQHC)
  • Muskegon, MI
  • NPI 1629066238
  Medicare reassignment NPD
• MGH Family Health Center

  dba Muskegon Family Care

  • Federally Qualified Health Center (FQHC)
  • Muskegon, MI
  • NPI 1255331583
  Medicare reassignment
• Hackley Community Care Center, Inc

  dba Hackley Community Care - Forest

  • Federally Qualified Health Center (FQHC)
  • Muskegon, MI
  • NPI 1427787621
  NPD

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1750772455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 BAKER ST FL 3",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494442157",
            "telephone_number": "231-737-1335",
            "fax_number": "231-737-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 BAKER ST FL 3",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494442157",
            "telephone_number": "231-737-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-17",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750772455",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Helpmates Living Assistants, Inc
• Terri Helton
• Susan Beth Henderson, BS PHARMACY RPH
• Janelle Howe Hendrian, D.O.
• Bruce Hendricks
• Daniel Craig Hendrickson, LMSW
• Amber Nicole Hepler
• Shelby Herber
• Connor Scott Herbert
• Heather Marie Herman-Eskola

• Physician Assistant in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.