Individual provider Active NPI

Andrew Hendrix, CRNA

  • Certified Registered Nurse Anesthetist
  • Vicksburg, MS
National Provider Identifier
1073960647
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
901397 Issued in MS
Practice address
2100 Highway 61 N
Vicksburg, MS 39183-8211
Phone
(601) 833-5000
Fax
(601) 883-5137
NPI assigned
May 24, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 885642 MS
Certified Registered Nurse Anesthetist 367500000X 901397 MS Primary

Addresses

Primary practice location

2100 Highway 61 N
Vicksburg, MS 39183-8211

Mailing address

105 Katherine Dr Ste G
Flowood, MS 39232-8857
Phone (601) 933-9521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AR, TX3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20160816002831 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042505943 Reassigns benefits to 2 organizations
I20241029000398 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042505943
I20241106001950 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042505943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consultants PAGroup PAC ID 4486637881, 102 clinicians

Practice addresses (Care Compare)

2100 Hwy 61 N
Vicksburg, MS 39183-8211
Phone (601) 883-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
885642MSMDRegistered Nurse
901397MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Ans Services of Arkansas PA CurrentSince Dec 1, 2024 Accepting new patients
Anesthesia Consultants PA Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2018 Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Oct 1, 2024 Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Oct 1, 2024 Accepting new patients
Northstar Anesthesia of Mississippi, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 5, 2017 Accepting new patients

Locations

1001 Towson Ave
Fort Smith, AR 72901
Phone (479) 441-3980

1030 River Oaks Dr
Jackson, MS 39232
Phone (601) 376-2165

2100 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-5001

265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 500-1254

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

Interoperability endpoints

  • Direct secure messaging: ahendrix219329@ummc.direct-ci.com

Organizations & group practices 6

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 1

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": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1073960647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 KATHERINE DR STE G",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328857",
            "telephone_number": "601-933-9521",
            "fax_number": "334-395-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838211",
            "telephone_number": "601-833-5000",
            "fax_number": "601-883-5137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "ANDREW",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-24",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "885642",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "901397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.