Phyllis Lillian Hendry, M.D.

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

ME54625 Issued in FL

Practice address

655 W 8TH St
Ufjp Emergency Medicine
Jacksonville, FL 32209-6511

Phone

(904) 244-4124

Fax

(904) 244-3432

NPI assigned

Jan 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: phendry59357@direct.shands.ufl.edu

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.

• University of Florida Jacksonville Physicians Inc

  • Diagnostic Radiology Physician
  • Jacksonville, FL
  • NPI 1326208695
  Medicare reassignment NPD

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

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216771200000",
    "number": "1114998200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "address_2": "UFJP EMERGENCY MEDICINE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-4124",
            "fax_number": "904-244-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRY",
        "first_name": "PHYLLIS",
        "middle_name": "LILLIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-28",
        "last_updated": "2008-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME54625",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "ME54625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000469829A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0549053-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alissa D Hendricks-Wenger, DO, PHD
• Whitney Alexander Hendricks, LMHC
• Jaia Hendrickson, RBT
• Amber Noel Hendrix, RBT
• Grace Hendrix, PA
• Mary Armanious Hendy, O.D.
• Breanna Henes, BCABA
• Samantha Marie Henke, PA-C
• Nichole Christiane Henkes
• Kimberly Michele Henley-Brown, DDS

• Pediatric Emergency Medicine (Pediatrics) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.