Michelle Renee Hendricks, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5012 Issued in OK

Practice address

4812 E 33Rd St
Tulsa, OK 74135-2038

Phone

(918) 622-4126

Fax

(918) 270-2398

NPI assigned

Mar 24, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Michelle Renee Prewitt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1364083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495670400000",
    "number": "1780926105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27950 S HIGHWAY 125",
            "address_2": "UNIT 39",
            "city": "MONKEY ISLAND",
            "state": "OK",
            "postal_code": "743313124",
            "telephone_number": "913-956-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4812 E 33RD ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352038",
            "telephone_number": "918-622-4126",
            "fax_number": "918-270-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-24",
        "last_updated": "2017-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MO",
            "license": "2013008000",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "KS",
            "license": "11-04532",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "PREWITT",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ryan Lane Hendren, M.D.
• Freddie Hendreson, LPC
• Misti Annette Hendrick, BSW
• Carolyn Hendricks
• James Warren Hendricks, M.D.
• Randall L. Hendricks, M.D.
• Andrew Hendrickson
• Bailey Hendrickson
• Faith Jan Hendrickson
• Scott E. Hendrickson, DO

• Physical Therapist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2017; 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.