Active NPI
Lanny Hendrickson
- Health Educator
- Fergus Falls, MN
National Provider Identifier
1790504272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- Practice address
- 1164 Friberg Ave
Fergus Falls, MN 56537-1580 - Phone
- (218) 739-4489
- NPI assigned
- Oct 10, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Health Educator | 174H00000X | Primary |
Addresses
Primary practice location
1164 Friberg Ave
Fergus Falls, MN 56537-1580
Mailing address
23178 W Wall Lake BND
Fergus Falls, MN 56537-8296
Phone (218) 205-0382
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728518400000",
"number": "1790504272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23178 W WALL LAKE BND",
"city": "FERGUS FALLS",
"state": "MN",
"postal_code": "565378296",
"telephone_number": "218-205-0382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1164 FRIBERG AVE",
"city": "FERGUS FALLS",
"state": "MN",
"postal_code": "565371580",
"telephone_number": "218-739-4489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICKSON",
"first_name": "LANNY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-10-10",
"last_updated": "2024-10-10",
"certification_date": "2024-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fergus Falls, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.