Paul Meredith Hendricks, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25018 Issued in TN

Practice address

163 Walnut Grove Church Rd
Dayton, TN 37321-6104

Phone

(423) 775-6668

Fax

(423) 775-1054

NPI assigned

Jul 5, 2006

Last updated

Feb 23, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

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

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.

• Chattanooga Emergency Medicine PLLC

  • Emergency Care Clinic/Center
  • Hixson, TN
  • NPI 1427264126
  Medicare reassignment NPD
• Chattanooga Emergency Medicine PLLC

  • Emergency Care Clinic/Center
  • Chattanooga, TN
  • NPI 1174739908
  NPD
• Emergency Medical Associates

  • Emergency Care Clinic/Center
  • Hixson, TN
  • NPI 1457381857
  NPD (past)
• Emergency Medical Associates

  • Emergency Care Clinic/Center
  • Chattanooga, TN
  • NPI 1982645396
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1225069503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4976 ALPHA LN",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435470",
            "telephone_number": "423-308-0280",
            "fax_number": "423-308-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 WALNUT GROVE CHURCH RD",
            "city": "DAYTON",
            "state": "TN",
            "postal_code": "373216104",
            "telephone_number": "423-775-6668",
            "fax_number": "423-775-1054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4980 Alpha Ln",
            "address_purpose": "LOCATION",
            "city": "Hixson",
            "state": "TN",
            "postal_code": "373435470",
            "country_code": "US",
            "telephone_number": "423-497-5359",
            "fax_number": "423-877-5208",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3354 Charger Dr",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374091265",
            "country_code": "US",
            "telephone_number": "423-265-6411",
            "fax_number": "423-756-4044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1720 Gunbarrel Rd Ste 410",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374213192",
            "country_code": "US",
            "telephone_number": "423-497-5359",
            "fax_number": "423-877-5208",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5864 Highway 153 Ste 112",
            "address_purpose": "LOCATION",
            "city": "Hixson",
            "state": "TN",
            "postal_code": "373435187",
            "country_code": "US",
            "telephone_number": "423-497-5359",
            "fax_number": "423-877-5208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "PAUL",
        "middle_name": "MEREDITH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "25018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000735743A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1516282",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Elaine Harris, PHARMD
• Robert W Harrison, PA-C
• Healthforce of Dayton, Inc
• Zoa Henderson, APRN, BSN, RN
• Mary Catherine Hendren, NP
• Timothy J Henry, D.C.
• Rodney Lynn Herra Jr.
• Charles Lynn Hester II
• Claire Williams Higginbotham, PA
• Hometown Primary Care, LLC

• Family Medicine Physician in Dayton, TN
• Providers in Dayton, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; 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.