KELLY J HENDRICKS (NPI# 1043329147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043329147 |
| Entity Type | Individual |
| Full Name | KELLY J HENDRICKS |
| Credential | M.D. |
| Practice Address |
5701 W 119th St Ste 410 Overland Park KS 66209-3721 |
| Practice Telephone | 9133456901 |
| Practice Fax Number | 9134694095 |
| Mailing Telephone | 9133456901 |
| Mailing Fax Number | 9134694095 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2017-11-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 04-30708 | KS | Allopathic & Osteopathic Physicians |
| Y | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
04-30708 | KS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | BCBS | 34266011 | 01 |
| KS | 200265840A | 05 | |
| MO | 209281302 | 05 | |
| KS | FIRSTGUARD | 580580 | 01 |
| RAILROAD MEDICARE | P00154501 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457773384 | Kelly Hendricks | Dentist | 1439 S Saint Francis Dr, Santa Fe, NM 87505 | 2014-01-13 |
| 1265856223 | Kelly Hendricks | Marriage & Family Therapist | 730 Medical Center Ct, Chula Vista, CA 91911-6618 | 2014-02-11 |
| 1821237785 | Kelly J Hendricks | Speech-Language Pathologist | 836 W Wellington Ave, Chicago, IL 60657-5147 | 2009-02-16 |
| Street Address |
5701 W 119TH ST STE 410 |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66209-3721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205353927 | Karina Ortiz | Nurse Practitioner | 5701 W 119th St Ste 410, Overland Park, KS 66209-3721 | 2017-08-23 |
| 1437541893 | Alicia R Cross-tipton | Physician Assistant | 5701 W 119th St Ste 410, Overland Park, KS 66209-3721 | 2015-02-23 |
| 1598052870 | Matthew Glenn Purtle | Physician Assistant | 5701 W 119th St Ste 410, Overland Park, KS 66209-3721 | 2011-07-07 |
| 1174849459 | Cameron Ledford | Orthopaedic Surgery | 5701 W 119th St Ste 410, Overland Park, KS 66209-3721 | 2010-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265900286 | Kansas Wellness Associates LLC | Family Medicine | 4300 W 133rd Street, Suite 200, Leawood, KS 66209 | 2018-11-07 |
| 1740781871 | Courtney Collins | Physical Therapy Assistant | 6830 W. 121st. Ct, Overland Park, KS 66209 | 2018-02-23 |
| 1295246015 | Meredith Meyer Bell | Nurse Practitioner | 5064 W 130th Terrace, Leawood, KS 66209 | 2017-10-19 |
| 1740712223 | Margaret Alice Luckert | Registered Nurse | 5701 W 119th Street Suite 220, Overland Park, KS 66209 | 2017-04-03 |
| 1609311133 | Kansas City Community Hospital, LLC | General Acute Care Hospital | 13200 State Line Road, Leawood, KS 66209 | 2016-12-19 |
| 1316492499 | Christy Vopat | Occupational Therapist | 4952 W. 129 Th Terr, Leawood, KS 66209 | 2016-08-18 |
| 1861846594 | Paige Aberasturi Penick | Nutritionist | 6709 W 119th St # 207, Overland Park, KS 66209 | 2016-04-19 |
| 1568827905 | Eating Disorder Treatment Associates, LLC | Clinic/Center | 12140 Nall Avenue, Suite 315, Overland Park, KS 66209 | 2015-12-30 |
| 1689056483 | Michael Hauber | Physical Therapist | 12728 State Line Rd, Leawood, KS 66209 | 2015-06-29 |
| 1033597000 | Brooke J Heppner Mft | Marriage & Family Therapist | 6711 W. 121st Street, Suite 101, Overland Park, KS 66209 | 2015-05-11 |
| Find all providers in zip 66209 | ||||
| Taxonomy Code | 207XS0114X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Adult Reconstructive Orthopaedic Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679030787 | Global Bone and Joint Clinic LLC | Orthopaedic Surgery | 2200 Summerlon Cir Ste B, Dodge City, KS 67801-2905 | 2019-02-25 |
| 1356549075 | Scott Alan Wingerter | Orthopaedic Surgery | 3651 College Blvd, Leawood, KS 66211-1910 | 2007-07-03 |
| 1659424471 | Mohamed Nizar N. Mahomed | Orthopaedic Surgery | 7550 W Village Cir, Suite 1, Wichita, KS 67205-9363 | 2007-01-18 |
| 1801837646 | James Joseph Jr. | Orthopaedic Surgery | 10100 E Shannon Woods St, Suite 100, Wichita, KS 67226-4104 | 2006-06-10 |
| 1013984699 | Paul C Pappademos | Orthopaedic Surgery | 2778 N Webb Rd, Wichita, KS 67226-8112 | 2006-03-02 |
| City | OVERLAND PARK |
| Zip Code | 66209 |
Please comment or provide details below to improve the information on KELLY J HENDRICKS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.