TARA G HENDRICKSON (NPI# 1831712546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831712546 |
| Entity Type | Individual |
| Full Name | TARA G HENDRICKSON |
| Credential | MD |
| Practice Address |
81 Ball Park Rd Harlan KY 40831 |
| Mailing Address |
1932 Highway 582 Pine Top KY 41843 |
| Practice Telephone | 6065738100 |
| Mailing Telephone | 5612675832 |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2020-05-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083982672 | Tara Lynn Hendrickson | Dental Hygienist | 3000 Market St Ne, Suite 228, Salem, OR 97301-1882 | 2011-12-09 |
| Street Address |
81 BALL PARK RD |
| City | HARLAN |
| State | KY |
| Zip Code | 40831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427054667 | Robin Magnani | Anesthesiology | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2005-06-22 |
| 1699399121 | Jordan Cecil Childers | Student in an Organized Health Care Education/Training Program | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2020-06-01 |
| 1881218535 | Mythili Kanthi Gudipati | Student in an Organized Health Care Education/Training Program | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2020-05-28 |
| 1497389936 | Keith Allen Goddard | Physical Medicine & Rehabilitation | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2020-02-24 |
| 1801434493 | Alexis Barnes | Physical Therapist | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2019-12-15 |
| 1497397863 | Casey Nicole Warf | Nurse Practitioner | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2019-10-17 |
| 1568010064 | Pine Mountain Emergency Group Limited Liability Company | Physician Assistant | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2019-08-28 |
| 1588216386 | Morgan Rutherford | Speech-Language Pathologist | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2019-07-11 |
| 1841842648 | Arika Gibbs | Occupational Therapist | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2019-07-11 |
| 1073173753 | Jane Katherine Heinold | Student in an Organized Health Care Education/Training Program | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2019-06-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730795261 | Hometown Urgent Care | Clinic/Center | 101 Green Terrace, Harlan, KY 40831 | 2020-09-21 |
| 1093243727 | Right Choice Counseling | Counselor | 53 Meadowbrook Lane, Harlan, KY 40831 | 2017-05-25 |
| 1639515935 | Harlan County Health Department Inc/ Cawood Elementary School | Public Health or Welfare | 51 Nola St, Cawood, KY 40831 | 2013-05-14 |
| 1487090775 | Harlan County Health Department Inc/james A Cawood Elementary School | Public Health or Welfare | 269 Ball Park Road, Harlan, KY 40831 | 2013-05-14 |
| 1336278175 | Newton Samuel Guy IIi | Dentist | 303 Mound St, Harlan, KY 40831 | 2007-03-05 |
| 1033256904 | Earlene A. Napier | Counselor | 15 Eula Gray Street, Harlan, KY 40831 | 2007-01-31 |
| 1538265400 | Kirpal S Sidhu | Orthopaedic Surgery | 29 Eula Gray Street, Harlan, KY 40831 | 2006-09-16 |
| 1508977067 | Gursharan Kaur Sidhu | Pediatrics | 29 Eula Gray St, Gursharan Kaur Sidhu Md, Harlan, KY 40831 | 2006-08-31 |
| 1649229725 | Timothy Logan Yost | Physical Therapist | 100 Professional Lane, Suite 102, Harlan, KY 40831 | 2006-05-08 |
| 1881693471 | Medical Services of America Inc | Emergency Response System Companies | 2307 W Hwy 72, Bldg B, Unit 2, Harlan, KY 40831 | 2005-07-18 |
| Find all providers in zip 40831 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912453804 | Leah Stutzman | Student in an Organized Health Care Education/Training Program | 16303 Sunset Pass, Harlan, IN 46743-9754 | 2016-08-30 |
| 1699399121 | Jordan Cecil Childers | Student in an Organized Health Care Education/Training Program | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2020-06-01 |
| 1881218535 | Mythili Kanthi Gudipati | Student in an Organized Health Care Education/Training Program | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2020-05-28 |
| 1073173753 | Jane Katherine Heinold | Student in an Organized Health Care Education/Training Program | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2019-06-16 |
| 1376103168 | Tuong Vi Cassandra Do | Student in an Organized Health Care Education/Training Program | 81 Ball Park Rd, Harlan, KY 40831-1701 | 2019-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780283721 | Brittany Michelle Woodward | Student in an Organized Health Care Education/Training Program | 107 Donovan Hts, Bardstown, KY 40004-8744 | 2020-10-21 |
| 1518566553 | Kenley N Joelson | Student in an Organized Health Care Education/Training Program | 2400 S 4th St Unit 710, Louisville, KY 40208-1526 | 2020-10-21 |
| 1235746512 | Nina S Smith | Student in an Organized Health Care Education/Training Program | 1115 Garvin Pl # 120, Louisville, KY 40203-3178 | 2020-09-30 |
| 1972117265 | Andrew Lanham | Student in an Organized Health Care Education/Training Program | 138 York St, Lexington, KY 40508-1879 | 2020-09-03 |
| 1215541834 | Sarah Sloan Goldberg | Student in an Organized Health Care Education/Training Program | 11201 Bodley Dr, Louisville, KY 40223-1387 | 2020-09-01 |
| 1104439439 | Rebekah Christine Preston | Student in an Organized Health Care Education/Training Program | 320 Colvin Cemetary Rd, Oil Springs, KY 41238-9152 | 2020-08-26 |
| 1639782949 | Vannarong Keo | Student in an Organized Health Care Education/Training Program | 805 Sam Christopher Ct, Richmond, KY 40475-3048 | 2020-08-26 |
| 1679184410 | Taylor Faulkner | Student in an Organized Health Care Education/Training Program | 2477 Ky Highway 1194, Stanford, KY 40484-8222 | 2020-08-14 |
| 1699392142 | Melon Nega | Student in an Organized Health Care Education/Training Program | 8076 Us 42, Florence, KY 41042-1474 | 2020-07-01 |
| 1649896648 | Katrina Antonette Casanova Tinoco | Student in an Organized Health Care Education/Training Program | 1325 North Race St., University of Louisville/glasgow, Glasgow, KY 42141 | 2020-06-25 |
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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.