Debi Hendricks, RD, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

LD-1200 Issued in NM

Practice address

717 Encino PL NE Ste 26
Albuquerque, NM 87102-2629

Phone

(505) 884-4545

NPI assigned

Aug 29, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1790405017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 SOOTHING MEADOWS DR NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871444089",
            "telephone_number": "505-947-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 ENCINO PL NE STE 26",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022629",
            "telephone_number": "505-884-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "DEBI",
        "credential": "RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NM",
            "license": "LD-1200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kidneyspecialistsofnm.com",
            "affiliation": "N",
            "endpointDescription": "Practice facility",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "717 Encino Pl NE Ste 26",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871022629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William G Henderson, MD
• Lisa D Hendle, CNP
• Carley Jean Hendren
• Carmelita Hendrick, RRT, AE-C
• Carla K. Hendricks, M.S., CCC-SLP
• Jenna E Hendricks
• Jodi Rae Hendricks, MA LMHC
• Mary Jo Hendricks
• Craig Hendrickson, ATC
• Destiny Hendrickson, RBT

• Registered Dietitian in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Registered Dietitian in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.