Mavis Hodges, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-11291 Issued in NC

Practice address

109 Wright Hill Dr
Durham, NC 27712-9094

Phone

(540) 598-4942

NPI assigned

Mar 9, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 31, 2025 through Jan 31, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Zufall Health Center,Inc

  • Community Health Clinic/Center
  • Dover, NJ
  • NPI 1902990880
  NPD (past)

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1326589490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WRIGHT HILL DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277129094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 WRIGHT HILL DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277129094",
            "telephone_number": "540-598-4942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4119 Capitol St",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277042153",
            "country_code": "US",
            "telephone_number": "919-294-9621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HODGES",
        "first_name": "MAVIS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-09",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Sheridan Hodges, PA
• Catrenia Parks Hodges, ACSW
• Jeannine B. Hodges, PTA
• Juliana Miller Hodges, DNP, RN, CPNP-PC
• Karen Elizabeth Hodges, PT
• Sarah H Hodges, M.D.
• Theodore Hodges
• Elizabeth Beatrice Hodgson, M.ED., MSW, LCSWA
• Kimberly Hodulik, PHARMD
• Langley K Hoeferkamp, LCMHCA

• Physician Assistant in Durham, NC
• Providers in Durham, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.