Individual provider Active NPI

Haley Nicole Hendrix

  • Physician Assistant
  • Roanoke, VA
National Provider Identifier
1073154647
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110009312 Issued in VA
Practice address
2331 Franklin Rd SW
Roanoke, VA 24014-1111
Phone
(540) 510-6200
Fax
(540) 857-5306
NPI assigned
Oct 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X 0110009312 VA Primary
Physician Assistant 363A00000X 4532 OK

Addresses

Primary practice location

2331 Franklin Rd SW
Roanoke, VA 24014-1111

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5352

Other practice location 1

3300 NW Expressway
Oklahoma City, OK 73112-4418
Phone (405) 949-3349

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210406000659 OK Practitioner - Physician Assistant 9032526298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tulsa Bone and Joint Associates PCGroup PAC ID 9335033802, 91 clinicians

Practice addresses (Care Compare)

4802 S 109TH E Ave
Tulsa, OK 74146-5822
Phone (918) 392-1513

4808 S 109TH E Ave
Tulsa, OK 74146-5822
Phone (918) 392-1513

Hospital & facility affiliations

  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4532OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Franklin Memorial Hospital CurrentSince Jul 31, 2023 Accepting new patients
Carilion Franklin Memorial Hospital CurrentSince Jul 31, 2023 Accepting new patients
Osu Health System Anesthesia Past Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients

Locations

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

180 Floyd Ave
Rocky Mount, VA 24151
Phone (540) 483-5277

Interoperability endpoints

  • Direct secure messaging: hhendrix319957@direct.saintfrancis.com
  • Direct secure messaging: hhendrix167840@direct.carilionclinic.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1073154647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713",
            "telephone_number": "540-224-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141111",
            "telephone_number": "540-510-6200",
            "fax_number": "540-857-5306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 NW Expressway",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731124418",
            "country_code": "US",
            "telephone_number": "405-949-3349",
            "fax_number": "405-552-0450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "HALEY",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009312",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4532",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.