Individual provider Active NPI

John Scott Hendrix, O.D.

  • Optometrist
  • Vincennes, IN
National Provider Identifier
1215991104
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
IN1915B Issued in IN
Practice address
223 Main St
Vincennes, IN 47591-1208
Phone
(812) 882-4809
Fax
(812) 882-4859
NPI assigned
Apr 17, 2006
Last updated
Nov 2, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IN1915B IN Primary

Addresses

Primary practice location

223 Main St
Vincennes, IN 47591-1208

Mailing address

1321 Audubon Rd
Vincennes, IN 47591-5003
Phone (812) 882-0306

Other identifiers 5

IdentifierTypeStateIssuer
0327640001OtherINDMERC
443490OtherINMEDICARE RAILROAD
351433409050OtherINCARESOURCE/MEDICAID
622531OtherINTRIGON
000000083973OtherINBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081119000718 IN Practitioner - Optometry 1355401431 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IN1915BINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hendrix Optometric Corporation Optometrist CurrentSince Oct 1, 2008 Accepting new patients

Locations

1057 A St NW
Linton, IN 47441
Phone (812) 847-8615

223 Main St
Vincennes, IN 47591
Phone (812) 882-4809

109 Cherry Tree Plz
Washington, IN 47501
Phone (812) 254-1600

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1215991104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 AUDUBON RD",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475915003",
            "telephone_number": "812-882-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 MAIN ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911208",
            "telephone_number": "812-882-4809",
            "fax_number": "812-882-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "JOHN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "IN1915B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0327640001",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "443490",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE/MEDICAID",
            "identifier": "351433409050",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIGON",
            "identifier": "622531",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000000083973",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

Verify at the official NPI Registry.