Active NPI
Jennifer Kendrick, PHYSICIAN ASSISTANT
- Physician Assistant
- Deer Park, TX
National Provider Identifier
1760501340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA02352
- Practice address
- 1314 Lovely LN
Deer Park, TX 77536-3675 - Phone
- (281) 542-9089
- NPI assigned
- Mar 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA02352 | TX | Primary |
Addresses
Primary practice location
1314 Lovely LN
Deer Park, TX 77536-3675
Mailing address
1314 Lovely LN
Deer Park, TX 77536-3675
Phone (281) 542-9089
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA02352 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222560000000",
"number": "1760501340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1314 LOVELY LN",
"city": "DEER PARK",
"state": "TX",
"postal_code": "775363675",
"telephone_number": "281-542-9089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1314 LOVELY LN",
"city": "DEER PARK",
"state": "TX",
"postal_code": "775363675",
"telephone_number": "281-542-9089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENDRICK",
"first_name": "JENNIFER",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2008-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA02352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deer Park, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.