Individual provider Active NPI

Gregory S Hendricks, MD

  • Sports Medicine (Family Medicine) Physician
  • Huntington, WV
National Provider Identifier
1487616868
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
21808 Issued in WV
Practice address
1600 Medical Center Dr
Suite G500
Huntington, WV 25701-3656
Phone
(304) 691-1100
Fax
(304) 691-1183
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21808 WV
Sports Medicine (Family Medicine) Physician 207QS0010X 21808 WV Primary

Addresses

Primary practice location

1600 Medical Center Dr
Suite G500
Huntington, WV 25701-3656

Mailing address

1600 Medical Center Dr
Suite G500
Huntington, WV 25701-3656
Phone (304) 691-1100

Other identifiers 3

IdentifierTypeStateIssuer
64098361MedicaidKY
2558754MedicaidOH
3810002242MedicaidWV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gregory.hendricks@marshall.cerner.direct.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20050516000001 WV Practitioner - Family PracticePractitioner - Sports Medicine 9830130319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
West Virginia University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Therapy and Health Centers IncGroup PAC ID 7416859574, shared by 6 NPIs, 263 clinicians

Practice addresses (Care Compare)

1600 Medical Ctr Dr
Suite G500
Huntington, WV 25701-3659
Phone (304) 691-1262

209 N 2ND St
Suite a
Ironton, OH 45638-1485
Phone (740) 534-1410

710 N Carol Malone Boulevard
Suite a
Grayson, KY 41143-1126
Phone (606) 474-0157

Hospital & facility affiliations

  • Cabell Huntington Hospital, Inc Hospital, Huntington, WV, CCN 510055
  • St Marys Medical Center Hospital, Huntington, WV, CCN 510007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21808WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians & Surgeons, Inc. CurrentSince May 1, 2005 Accepting new patients
University Physicians & Surgeons, Inc Family Medicine CurrentSince May 1, 2005 Accepting new patients

Locations

1600 Medical Center Dr
Huntington, WV 25701
Phone (304) 691-1100

1600 Medical Center Dr
Ste G500
Huntington, WV 25701
Phone (304) 691-1262

1600 Medical Center Dr
#B51
Huntington, WV 25701
Phone (304) 691-8850

2211 3rd Ave
Huntington, WV 25703
Phone (304) 691-1880

1600 Medical Center Dr
Ste 3500
Huntington, WV 25701
Phone (304) 691-1300

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1487616868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR",
            "address_2": "SUITE G500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013656",
            "telephone_number": "304-691-1100",
            "fax_number": "304-691-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR",
            "address_2": "SUITE G500",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013656",
            "telephone_number": "304-691-1100",
            "fax_number": "304-691-1183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "GREGORY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "21808",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WV",
            "license": "21808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64098361",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2558754",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810002242",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gregory.hendricks@marshall.cerner.direct.com",
            "affiliation": "N",
            "address_1": "1600 Medical Center Dr",
            "address_2": "Suite G500",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257013656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.