Active NPI
Harvey Hendricks
- Surgical Technologist
- Acworth, GA
National Provider Identifier
1811043318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- 032135-02
- Practice address
- 4625 Saddle Gate LN
Acworth, GA 30101-5286 - Phone
- (770) 529-0928
- Fax
- (770) 529-0928
- NPI assigned
- Jan 26, 2007
- 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 |
|---|---|---|---|---|
| Surgical Technologist | 246ZS0410X | 032135-02 | GA | Primary |
Addresses
Primary practice location
4625 Saddle Gate LN
Acworth, GA 30101-5286
Mailing address
4625 Saddle Gate Lane
Acworth, GA 30101
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032135-02 | GA | MD | Surgical Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Assistant Surgical Services Inc. | Surgical Technologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Surgical Technologist
- Acworth, GA
- NPI 1528114337
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811043318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4625 SADDLE GATE LANE",
"city": "ACWORTH",
"state": "GA",
"postal_code": "30101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4625 SADDLE GATE LN",
"city": "ACWORTH",
"state": "GA",
"postal_code": "301015286",
"telephone_number": "770-529-0928",
"fax_number": "770-529-0928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICKS",
"first_name": "HARVEY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "GA",
"license": "032135-02",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Acworth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.