Individual provider Active NPI

Asa Gold Hendrick II, MD

  • Pediatrics Physician
  • Chapel Hill, NC
National Provider Identifier
1114554656
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
202302131 Issued in NC
Practice address
300 Market St Ste 112
Chapel Hill, NC 27516-4493
Phone
(919) 969-9611
NPI assigned
Mar 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 202302131 NC Primary

Addresses

Primary practice location

300 Market St Ste 112
Chapel Hill, NC 27516-4493

Mailing address

4705 University Dr BLDG 700
Durham, NC 27707-3489
Phone (919) 237-1337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240207001492 NC Practitioner - Pediatric Medicine 1557704590 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Avance Care, PA CurrentSince Mar 1, 2024 Accepting new patients
Village Pediatrics of Chapel Hill, PA Pediatrics PastSince Jan 21, 2024 Accepting new patients

Locations

300 Market St
Ste 112
Chapel Hill, NC 27516
Phone (919) 632-8699

4705 University Dr
Bldg 700
Durham, NC 27707
Phone (919) 237-1337

7510 Ramble Way
Ste 107
Raleigh, NC 27616
Phone (919) 277-8880

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1114554656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 UNIVERSITY DR BLDG 700",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073489",
            "telephone_number": "919-237-1337",
            "fax_number": "919-237-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MARKET ST STE 112",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275164493",
            "telephone_number": "919-969-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICK",
        "first_name": "ASA",
        "middle_name": "GOLD",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "202302131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.