Active NPI
Amy Nicole Hendrickson
- Case Manager/Care Coordinator
- Ely, NV
National Provider Identifier
1922486927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 171M00000X
- Practice address
- 740 Park Ave
Ely, NV 89301-2797 - Phone
- (775) 289-1640
- NPI assigned
- May 11, 2015
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 171M00000X | NV | Primary |
Addresses
Primary practice location
740 Park Ave
Ely, NV 89301-2797
Mailing address
740 Park Avenue
Ely, NV 89301
Phone (775) 289-1640
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 |
|---|---|---|---|
| 171M00000X | NV | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431302400000",
"number": "1922486927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "740 PARK AVENUE",
"city": "ELY",
"state": "NV",
"postal_code": "89301",
"telephone_number": "775-289-1640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "740 PARK AVE",
"city": "ELY",
"state": "NV",
"postal_code": "893012797",
"telephone_number": "775-289-1640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICKSON",
"first_name": "AMY",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-11",
"last_updated": "2015-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NV",
"license": "171M00000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ely, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.