NPIMap

Organization Active NPI

Hendrix Medical Services PLLC

  • Family Medicine Physician
  • Paragould, AR
National Provider Identifier
1023157682
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-0965 Issued in AR
Legal business name
HENDRIX MEDICAL SERVICES PLLC
Practice address
2709 W Kingshighway
Suite 6
Paragould, AR 72450-4141
Phone
(870) 236-7272
Fax
(870) 236-7275
NPI assigned
Feb 6, 2007
Organization subpart
Yes
Parent organization
HENDRIX MEDICAL SERVICES PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Barry Dewane Hendrix, M.D.NPI 1558440180
Title
Owner Physician
Phone
(870) 236-7272

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X E-0965 AR Primary

Addresses

Primary practice location

2709 W Kingshighway
Suite 6
Paragould, AR 72450-4141

Mailing address

2709 W Kingshighway
Suite 6
Paragould, AR 72450-4141
Phone (870) 236-7272

Other identifiers 2

IdentifierTypeStateIssuer
130230001MedicaidAR
CI2041OtherARRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070501000329 AR Part B Supplier - Clinic/Group Practice 7113992454 Receives reassigned benefits from 3 practitioners
Practice locations: Paragould, AR

National Provider Directory

National Provider Directory
Part of
Hendrix Medical Services PLLC

Locations

2709 W Kingshighway
Ste 6
Paragould, AR 72450
Phone (870) 236-7272

2709 W Kingshighway
Ste 8
Paragould, AR 72450
Phone (870) 236-3388

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489536000000",
    "number": "1023157682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 W KINGSHIGHWAY",
            "address_2": "SUITE 6",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724504141",
            "telephone_number": "870-236-7272",
            "fax_number": "870-236-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 W KINGSHIGHWAY",
            "address_2": "SUITE 6",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724504141",
            "telephone_number": "870-236-7272",
            "fax_number": "870-236-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDRIX MEDICAL SERVICES PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HENDRIX MEDICAL SERVICES PLLC",
        "enumeration_date": "2007-02-06",
        "last_updated": "2017-03-15",
        "status": "A",
        "authorized_official_last_name": "HENDRIX",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "DEWANE",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "870-236-7272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-0965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130230001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI2041",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paragould, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.