NPIMap

Individual provider Active NPI

Sydney Lance Hendrix, M.D.

  • Internal Medicine Physician
  • Jesup, GA
National Provider Identifier
1679643712
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
GA056459 Issued in GA
Practice address
351 Peachtree St
Jesup, GA 31545-0245
Phone
(912) 530-6582
Fax
(912) 530-6584
NPI assigned
Nov 8, 2006
Last updated
Nov 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X GA056459 GA Primary
Internal Medicine Physician 207R00000X ME88508 FL

Addresses

Primary practice location

351 Peachtree St
Jesup, GA 31545-0245

Mailing address

351 Peachtree St
Jesup, GA 31545-0245
Phone (912) 530-6582

Other identifiers 3

IdentifierTypeStateIssuer
189166661BMedicaidGA
966221OtherGABLUE CROSS BLUE SHIELD GA
P00402900OtherGARAILROAD MEDICARE PTAN (GROUP)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050823000222 GA Practitioner - Internal Medicine 1850362377 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Georgia School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine of Southeast GeorgiaGroup PAC ID 2264532019, 4 clinicians

Practice addresses (Care Compare)

351 Peachtree St
Jesup, GA 31545-0245
Phone (912) 530-6582

865 N 1St St
Jesup, GA 31545-1618
Phone (912) 427-6811

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
76.86
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy24
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
GA056459GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine of Southeast Georgia Internal Medicine CurrentSince Aug 2, 2005 Accepting new patients
Hospital Authority of Wayne County Georgia CurrentSince May 1, 2012 Accepting new patients
Hospital Authority of Wayne County Georgia Current Accepting new patients
Hospital Authority of Wayne County Georgia CurrentSince May 1, 2012 Accepting new patients
Hospital Authority of Wayne County, Georgia Current Accepting new patients

Locations

228 Memorial Dr
Jesup, GA 31545
Phone (912) 530-6582

351 Peachtree St
Jesup, GA 31545
Phone (912) 530-6582

865 N 1St St
Jesup, GA 31545
Phone (912) 427-6811

865 S 1st St
Jesup, GA 31545
Phone (912) 427-6811

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDDBDA
  • Direct secure messaging: sydneyhendrix@wmhjesup.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wayne Memorial HospitalJesup, GA, CCN 110124 Hospital Corporate Officer Jul 1, 2008
Wayne Memorial HospitalJesup, GA, CCN 11U124 Hospital Corporate Officer Jul 1, 2008

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1679643712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 PEACHTREE ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450245",
            "telephone_number": "912-530-6582",
            "fax_number": "912-530-6584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 PEACHTREE ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450245",
            "telephone_number": "912-530-6582",
            "fax_number": "912-530-6584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "SYDNEY",
        "middle_name": "LANCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "GA056459",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME88508",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189166661B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD GA",
            "identifier": "966221",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN (GROUP)",
            "identifier": "P00402900",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jesup, GA

Sources for this page

Verify at the official NPI Registry.