NPIMap

Organization Active NPI

Hendricks Family Practice, PC

  • Family Medicine Physician
  • Decatur, AL
National Provider Identifier
1568419810
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26531 Issued in AL
Legal business name
HENDRICKS FAMILY PRACTICE, PC
Practice address
2699 Sandlin Rd SW
Suite B-8
Decatur, AL 35601-7343
Phone
(256) 301-0560
Fax
(256) 301-0563
NPI assigned
May 30, 2006
Last updated
Jul 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Authorized official

Name
Dr. Malcolm R Hendricks, M.D.
Title
Co-Owner/Physician
Phone
(256) 301-0560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26531 AL Primary

Addresses

Primary practice location

2699 Sandlin Rd SW
Suite B-8
Decatur, AL 35601-7343

Mailing address

2699 Sandlin Rd SW
Suite B-8
Decatur, AL 35601-7343
Phone (256) 301-0560

Other identifiers 1

IdentifierTypeStateIssuer
102364MedicaidAL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address malcolm.hendricks.1@21177.direct.athenahealth.com Health Information Exchange (HIE)
Direct Messaging Address brandi.greeson.1@21177.direct.athenahealth.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: brandi.greeson.1@21177.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/21177/brand/1/csg/1/fhir/r4
  • Direct secure messaging: malcolm.hendricks.1@21177.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1568419810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2699 SANDLIN RD SW",
            "address_2": "SUITE B-8",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356017343",
            "telephone_number": "256-301-0560",
            "fax_number": "256-301-0563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2699 SANDLIN RD SW",
            "address_2": "SUITE B-8",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356017343",
            "telephone_number": "256-301-0560",
            "fax_number": "256-301-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDRICKS FAMILY PRACTICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "MALCOLM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CO-OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "256-301-0560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "26531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102364",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "malcolm.hendricks.1@21177.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Dr. Hendricks' Direct Messaging",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2699 Sandlin Rd SW",
            "address_2": "Suite B-8",
            "city": "Decatur",
            "state": "AL",
            "country_code": "US",
            "postal_code": "356017343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brandi.greeson.1@21177.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Brandi's direct messaging",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2699 Sandlin Rd SW",
            "address_2": "Suite B-8",
            "city": "Decatur",
            "state": "AL",
            "country_code": "US",
            "postal_code": "356017343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.