DEREK HENDRICKSON


Address: 1200 Sixth St Ste 200, Traverse City, MI 49684-2369
Phone: 2319355800

DEREK HENDRICKSON (NPI# 1043857196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1043857196
Entity Type Individual
Full Name DEREK HENDRICKSON
Credential PA-C
Practice Address 1200 Sixth St Ste 200
Traverse City
MI 49684-2369
Practice Telephone 2319355800
Practice Fax Number 2319355799
Mailing Telephone 2319355800
Mailing Fax Number 2319355799
Enumeration Date 2019-12-09
Last Update Date 2019-12-10
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
5601009719 MI Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1200 SIXTH ST STE 200
City TRAVERSE CITY
State MI
Zip Code 49684-2369

Providers in the same location

NPI Name Taxonomy Address Enumeration
1063407799 Brian D Jaffe Internal Medicine 1200 Sixth St Ste 200, Traverse City, MI 49684-2369 2005-09-19
1992357883 Kristen Kennedy Nurse Practitioner 1200 Sixth St Ste 200, Traverse City, MI 49684-2369 2019-07-11
1649743832 Dawn Colleen Borgula Nurse Practitioner 1200 Sixth St Ste 200, Traverse City, MI 49684-2369 2019-01-10
1811356728 Adam Leech Physician Assistant 1200 Sixth St Ste 200, Traverse City, MI 49684-2369 2016-02-19
1326406133 Zita Antoinette Muladore Nurse Practitioner 1200 Sixth St Ste 200, Traverse City, MI 49684-2369 2016-02-08
1477986529 Mark Steven Carrier Nurse Practitioner 1200 Sixth St Ste 200, Traverse City, MI 49684-2369 2013-08-13
1326481920 Colleen Knecht Sabatine Nurse Practitioner 1200 Sixth St Ste 200, Traverse City, MI 49684-2369 2013-04-12
1467606350 Carrie M Sorensen Physician Assistant 1200 Sixth St Ste 200, Traverse City, MI 49684-2369 2008-11-05
1730343583 Kristen N. Maurice Internal Medicine 1200 Sixth St Ste 200, Traverse City, MI 49684-2369 2008-07-10
1093999476 Rebecca J Eichberger Nurse Practitioner 1200 Sixth St Ste 200, Traverse City, MI 49684-2369 2007-12-20
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124641758 Karen Anne Paulosky Registered Nurse 226 S Madison St, Traverse City, MI 49684 2020-05-18
1891314795 Jaclyn Elizabeth Sylvain Student in an Organized Health Care Education/Training Program Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 2020-04-10
1285282988 Madelyn Drumm Dietitian, Registered 217 S. Madison St., Suite 3022, Traverse City, MI 49684 2019-08-27
1265917686 Kacie Danielle Heading Social Worker 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 2018-10-02
1881178325 Jacob White Ph.d., Pllc Psychologist 3537 W. Front Street, Suite F, Traverse City, MI 49684 2018-09-20
1144702572 Constance Baab, Phd, Lmsw, Pllc Social Worker 3301 Veterans Drive Suite 127, Traverse City, MI 49684 2018-09-01
1346732880 The Skin Cancer and Dermatology Center Plc Dermatology 1225 W Front St Ste 2, Traverse City, MI 49684 2018-05-31
1790283851 Lisa Louise Kleyps Massage Therapist 3337 W. South Airport Road #2, Traverse City, MI 49684 2018-01-24
1114447646 Brittany Alexandra Prior Physical Therapist 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 2017-06-26
1568902963 Jennifer Scott Behavior Technician 515 W 14th St Unit D, Traverse City, MI 49684 2017-03-03
Find all providers in zip 49684

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1992810360 Laura Leigh Worthington Physician Assistant 13491 S Bugai Rd, Traverse City, MI 49684-8421 2006-08-19
1598752768 Perry Ray Tiernan Physician Assistant 3074 Us 31 S, Traverse City, MI 49684-4533 2005-10-04
1114928637 Mary Kathryn Douglas Physician Assistant 5015 N Royal Dr, Traverse City, MI 49684-9292 2005-08-09
1649735226 Morgan Kelsey Olson Physician Assistant 1105 Sixth St, Traverse City, MI 49684-2345 2019-02-07
1851833198 Katharine Ella Venner Physician Assistant 1105 6th St, Traverse City, MI 49684-2349 2016-11-16
1427417708 Christine E Miliken Physician Assistant 3074 N Us 31 S, Traverse City, MI 49684-4533 2016-02-16
1144503491 Jesse Kogelman Physician Assistant 550 Munson Ave, Suite 200, Traverse City, MI 49686-3580 2011-09-22
1952691768 Alisha Marie Cole Physician Assistant 4045 W Royal Dr, Traverse City, MI 49684-8965 2011-04-13
1467606350 Carrie M Sorensen Physician Assistant 1200 Sixth St Ste 200, Traverse City, MI 49684-2369 2008-11-05
1336397538 Andrij Ihor Lawrin Physician Assistant 1105 Sixth St, Traverse City, MI 49684-2345 2008-09-03
Find all providers in TRAVERSE CITY

Competitor

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City TRAVERSE CITY
Zip Code 49684

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Dataset Information

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.

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