DR. JEFFERSON L HENDRICKSON (NPI# 1164781811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164781811 |
| Entity Type | Individual |
| Full Name | DR. JEFFERSON L HENDRICKSON |
| Credential | M.D. |
| Practice Address |
1106 Annapolis Rd Odenton MD 21113-1637 |
| Mailing Address |
14964 Belle Ami Dr Laurel MD 20707-3600 |
| Practice Telephone | 4108741400 |
| Mailing Telephone | 3014988455 |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2016-09-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | D0080819 | MD | Allopathic & Osteopathic Physicians |
| Street Address |
1106 ANNAPOLIS RD |
| City | ODENTON |
| State | MD |
| Zip Code | 21113-1637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427096221 | Patricia Gillen | Family Medicine | 1106 Annapolis Rd, Suite 310, Odenton, MD 21113-1637 | 2006-06-03 |
| 1689124729 | Aamg Physical Therapy, LLC | Speech-Language Pathologist | 1106 Annapolis Rd, Suite 120, Odenton, MD 21113-1637 | 2016-10-13 |
| 1508248444 | Morgan Mowery | Physical Therapist | 1106 Annapolis Rd, Odenton, MD 21113-1637 | 2015-06-28 |
| 1023415296 | Alison Rose | Occupational Therapist | 1106 Annapolis Rd, Ste 130, Odenton, MD 21113-1637 | 2014-12-03 |
| 1326443250 | Shannon P Robinson | Physical Therapist | 1106 Annapolis Rd, Odenton, MD 21113-1637 | 2014-11-04 |
| 1164838249 | Shelia Craig Whiteman | Physical Therapist | 1106 Annapolis Rd, Odenton, MD 21113-1637 | 2014-07-09 |
| 1760738876 | Raina Crawford | Nurse Practitioner | 1106 Annapolis Rd, Suite 310, Odenton, MD 21113-1637 | 2012-07-26 |
| 1790090009 | Lindsay T Ciocco | Optometrist | 1106 Annapolis Rd, Suite 290, Odenton, MD 21113-1637 | 2010-08-11 |
| 1528204831 | Dawn M. Duran | Physical Therapist | 1106 Annapolis Rd, Odenton, MD 21113-1637 | 2008-12-17 |
| 1770608721 | Robert Bradley Boughan | Internal Medicine | 1106 Annapolis Rd, Suite 310, Odenton, MD 21113-1602 | 2007-03-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366938599 | Dmv Community Health Services LLC | Clinic/Center | 87778 Pine Orchard Parkway, Odenton, MD 21113 | 2018-07-11 |
| 1285125997 | Edward Lashawn Harvey | Specialist | 207 Ammunition Ave, Odenton, MD 21113 | 2018-05-29 |
| 1275041394 | Aimee Kathleen Olivera Sanchez | Social Worker | 2150 Colonel Way, Odenton, MD 21113 | 2018-01-11 |
| 1891214714 | Bincy Kuttiplackal Mathai | Dentist | 1135 Annapolis Road, Odenton, MD 21113 | 2017-09-12 |
| 1730601949 | Amanda Mary Jackiewicz | Physician Assistant | Greater Maryland Pain Management, 1130 Annapolis Rd Suite 100, Odenton, MD 21113 | 2017-07-10 |
| 1346771235 | Pattrena Reid | Respiratory Therapist, Registered | 115 Bragg Blvd, Odenton, MD 21113 | 2017-03-23 |
| 1225572233 | Pamela Denise Ponder | Internal Medicine | 2603 Portola Court, Odenton, MD 21113 | 2016-12-09 |
| 1285052803 | Diana Nicole Spell | Internal Medicine | Johns Hopkins Community Physicians - Odenton, 1106 Annapolis Road, Odenton, MD 21113 | 2014-04-01 |
| 1730431321 | Orthopedic Physicians of Annapolis LLC | Prosthetic/Orthotic Supplier | 1106 Annapolis Road, Suite 130, Odenton, MD 21113 | 2012-10-08 |
| 1275869463 | Olubukola Fakunle | Pharmacist | 2294 Blue Water Blvd, Weis Pharmacy, Odenton, MD 21113 | 2009-10-23 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285052803 | Diana Nicole Spell | Internal Medicine | Johns Hopkins Community Physicians - Odenton, 1106 Annapolis Road, Odenton, MD 21113 | 2014-04-01 |
| 1073591665 | Wanda Rivera | Internal Medicine | 1132 Annapolis Rd, Odenton, MD 21113 | 2006-01-04 |
| 1225272677 | Shawna Michelle Reshard | Internal Medicine | 1106 Annapolis Rd Ste 310, Odenton, MD 21113 | 2009-04-29 |
| 1770608721 | Robert Bradley Boughan | Internal Medicine | 1106 Annapolis Rd, Suite 310, Odenton, MD 21113-1602 | 2007-03-20 |
| 1407970353 | Kathryn Strain | Internal Medicine | 1106 Annapolis Rd Ste 310, Odenton, MD 21113 | 2007-03-18 |
| 1508980459 | Mark H. Davino | Internal Medicine | 1106 Annapolis Rd, Suite 310, Odenton, MD 21113-1647 | 2007-03-18 |
| 1811031297 | Michael C. Albert | Internal Medicine | 1106 Annapolis Rd Ste 310, Odenton, MD 21113 | 2007-02-17 |
| 1033264270 | Mollie M Davis | Internal Medicine | 1106 Annapolis Rd Ste 310, Odenton, MD 21113 | 2007-01-25 |
| 1790834299 | Holly Eyler-yeatman | Internal Medicine | 1106 Annapolis Rd, Suite 310, Odenton, MD 21113-1637 | 2007-01-10 |
| 1477643013 | Seema Aliasgar Gadiwalla | Internal Medicine | 1106 Annapolis Rd, Odenton, MD 21113 | 2006-10-13 |
| Find all providers in ODENTON | ||||
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| 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.