Individual provider Active NPI

Thomas Hendriks, MBBS, MPHIL, FRACS

  • Otolaryngology Physician
  • Charleston, SC
National Provider Identifier
1659119790
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
LL95081 Issued in SC
Practice address
9228 Medical Plaza Dr
Charleston, SC 29406-9125
Phone
(843) 574-5693
NPI assigned
Jul 15, 2024
Reactivated
Aug 11, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X LL95081 SC Primary

Addresses

Primary practice location

9228 Medical Plaza Dr
Charleston, SC 29406-9125

Mailing address

426 Bank St
Mt Pleasant, SC 29464-4705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20250911001369 SC Practitioner - Otolaryngology 8123521614

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2000 Health Park Dr
Brentwood, TN 37027-4692

Hospital & facility affiliations

  • Trident Medical Center Hospital, Charleston, SC, CCN 420079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Hospital & facility affiliations 1

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": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1659119790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 BANK ST",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294644705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9228 MEDICAL PLAZA DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069125",
            "telephone_number": "843-574-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIKS",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MBBS, MPHIL, FRACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-15",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "deactivation_date": "2025-05-20",
        "reactivation_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "LL95081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.