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Deactivated NPI 1184280356 Deactivated / Inactive NPI Female Practitioner

Stacy Marie Hendrickson

Licensed Practical Nurse • Dayton, OH

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Stacy Hendrickson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 14, 2019
NPI Deactivation Date July 17, 2020
Total Practice Duration ~1 Years of Practice (2019 – 2020)

Professional Overview & Biography Verified Profile Summary

Stacy Hendrickson was a registered Licensed Practical Nurse practicing in Dayton, OH. Throughout an active medical career spanning 1 years, Stacy Hendrickson provided care at the practice location at 4977 NORTHCUTT PL until profile deactivation on 2020-07-17.

Practice Location & Contact Primary Location

Practice Address

4977 Northcutt Pl

Dayton, OH 454143839

Telephone 9373676269
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Dayton, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.0 Yrs
Regional Practice Density
655 Specialists

Practicing in Dayton, OH (13034 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License OH LPN.167770.MEDS-IV

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Kenesha Howard , RN

Registered Nurse

NPI 1154976280

Registered Nurse

Dawn Brink , RN

Registered Nurse

NPI 1548818453

Registered Nurse

Ta'nesha Casey , LPN

Licensed Practical Nurse

NPI 1629627385

Licensed Practical Nurse

Nina Hoagland , RN

Registered Nurse

NPI 1922653161

Registered Nurse

Rebecca Campana , LSW

Social Worker - Clinical

NPI 1972169225

Licensed Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 17, 2020

Record deactivated on July 17, 2020

NPI Profile Active May 14, 2019

NPI status registered as active in NPPES database

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Updated Practice Location May 14, 2019

Registered at 4977 NORTHCUTT PL, DAYTON, OH 454143839 (Tel: 9373676269)

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Updated Business Mailing Address May 14, 2019

Registered at 1503 COVENTRY RD, DAYTON, OH 454103210 (Tel: 9373044706)

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Provider Name / Credentials Updated May 14, 2019

Recorded as STACY HENDRICKSON

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 14, 2019

Licensed Practical Nurse (License #LPN.167770.MEDS-IV in OH)

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Initial NPI Registration & Enumeration May 14, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1184280356
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 14, 2019
Last Update: May 14, 2019
Deactivation Date: July 17, 2020

Mailing Address

1503 Coventry Rd

Dayton, OH 454103210

Phone: 9373044706

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.