John Hampton Hendrick Jr., PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA709 Issued in SC

Practice address

2180 Henry Tecklenburg Dr
Charleston, SC 29414

Phone

(843) 556-8886

Fax

(843) 556-8850

NPI assigned

Apr 8, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in VA, SC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Epiphany Dermatology of South Carolina LLCGroup PAC ID 8527049865, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bon Secours-St Francis Xavier Hospital Hospital, Charleston, SC, CCN 420065

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: john.hendrick@epiphanyderm.emadirect.md

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.

• Epiphany Dermatology of South Carolina LLC

  • Dermatology Physician
  • Greenville, SC
  • NPI 1861565996
  Medicare reassignment Care Compare group
• Dermatology and Laser Center of Charleston PA

  • Dermatology Physician
  • Charleston, SC
  • NPI 1124198361
  Medicare reassignment
• Dermatology Center PC

  • Dermatology Physician
  • Fredericksburg, VA
  • NPI 1073688768
  Medicare reassignment
• Carolina Orthopaedic and Neurosurgical Associates

  • Orthopaedic Surgery Physician
  • Spartanburg, SC
  • NPI 1568454056
  NPD (past)
• Carolina Orthopaedic and Neurosurgical Associates

  • Orthopaedic Surgery Physician
  • Columbus, NC
  • NPI 1083309074
  NPD (past)
• MCV Associated Physicians

  • Anesthesiology Physician
  • Richmond, VA
  • NPI 1710959457
  NPD (past)

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

• Bon Secours St. Francis Xavier Hospital Inc.

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1851361778
  Care Compare affiliation

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1528021896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145798",
            "telephone_number": "438-556-8886",
            "fax_number": "843-556-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29414",
            "telephone_number": "843-556-8886",
            "fax_number": "843-556-8850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1364 Ashley River Rd",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "29407",
            "country_code": "US",
            "telephone_number": "843-556-8886",
            "fax_number": "843-556-8850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRICK",
        "first_name": "JOHN",
        "middle_name": "HAMPTON",
        "name_suffix": "Jr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "PA709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01048436",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Dianne Henderson, MS CGC
• Heather Tripp Henderson, MD
• Irulan Rosemarie Henderson
• Makayla Henderson
• Denise Hendler, MASSAGE THERAPIST
• Susanne H Hendricks, R.D.
• Brooke K Hendrickson, APRN
• Lindsey Hendrickson, NP
• Thomas Hendriks, MBBS, MPHIL, FRACS
• Bailey Hendrix

• Physician Assistant in Charleston, SC
• Providers in Charleston, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.