Individual provider Active NPI

Joseph E Hendrix, P.A.

  • Physician Assistant
  • Valdosta, GA
National Provider Identifier
1659392249
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
004269 Issued in GA
Practice address
2501 N Patterson St
Valdosta, GA 31602
Phone
(229) 433-1000
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 004269 GA Primary

Addresses

Primary practice location

2501 N Patterson St
Valdosta, GA 31602

Mailing address

2501 N Patterson St
Valdosta, GA 31602-1735
Phone (229) 433-1000

Other practice location 1

3301 N Oak Street Ext
Valdosta, GA 31605-1014
Phone (229) 242-6061

Other identifiers 1

IdentifierTypeStateIssuer
594818796JMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040712000705 GA Practitioner - Physician Assistant 4880672237 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
004269GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Em-I Medical Services, LLC Physician Assistant CurrentSince Dec 1, 2019 Accepting new patients
Georgia Em-I Medical Services. LLC Physician Assistant CurrentSince Dec 1, 2019 Accepting new patients
Applecare LLC Current Accepting new patients
Southland-Nashville Emergency Services, LLC Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Physicians Care Center LLC Past Accepting new patients
Sheridan Emergency Physician Services of Georgia,LLC Physician Assistant Past Accepting new patients
Summit Macon LLC Past Accepting new patients
BCH Medical Investors, LLC Past Accepting new patients

Locations

200 Allen Memorial Dr
Bremen, GA 30110
Phone (770) 537-5851

1111 Glynco Pkwy
Ste 10
Brunswick, GA 31525
Phone (912) 264-9111

400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

Organizations & group practices 10

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1659392249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021735",
            "telephone_number": "229-433-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31602",
            "telephone_number": "229-433-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3301 N Oak Street Ext",
            "address_purpose": "LOCATION",
            "city": "Valdosta",
            "state": "GA",
            "postal_code": "316051014",
            "country_code": "US",
            "telephone_number": "229-242-6061",
            "fax_number": "229-242-6151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "JOSEPH",
        "middle_name": "E",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "594818796J",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.