Individual provider Active NPI

Susan Walsh Hendrix, O.D.

  • Optometrist
  • Fayetteville, NC
National Provider Identifier
1659329654
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1439 Issued in NC
Practice address
216 Northstone PL
Fayetteville, NC 28303-5494
Phone
(910) 826-0100
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1439 NC Primary

Addresses

Primary practice location

216 Northstone PL
Fayetteville, NC 28303-5494

Mailing address

4303 Fayetteville Rd
Raeford, NC 28376-8052
Phone (910) 875-6200

Other identifiers 2

IdentifierTypeStateIssuer
890937BMedicaidNC
0937BOtherNCBCBS OF NC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100929001393 NC Practitioner - Optometry 7517083322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Risk Optometric Associates, PAGroup PAC ID 8325110034, 7 clinicians

Practice addresses (Care Compare)

216 Northstone PL
Fayetteville, NC 28303-5494

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Risk Optometric Associates, PA Optometrist CurrentSince Sep 1, 1997 Accepting new patients

Locations

1550 Skibo Rd
Fayetteville, NC 28303
Phone (910) 868-3910

7701 S Raeford Rd
Fayetteville, NC 28304
Phone (910) 826-0100

4601 Ramsey St
Fayetteville, NC 28311
Phone (910) 488-2828

1515 Skibo Rd
Fayetteville, NC 28303
Phone (910) 868-3910

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1659329654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4303 FAYETTEVILLE RD",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283768052",
            "telephone_number": "910-875-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 NORTHSTONE PL",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035494",
            "telephone_number": "910-826-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "SUSAN",
        "middle_name": "WALSH",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890937B",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "0937B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.