Individual provider Active NPI

Jason L Hendrix, OD

  • Optometrist
  • Wilmington, NC
National Provider Identifier
1699866145
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1904 Issued in NC
Practice address
8262 Market St Ste 103
Wilmington, NC 28411-9681
Phone
(910) 686-3396
Fax
(910) 686-3397
NPI assigned
Sep 28, 2006
Last updated
Sep 25, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1904 NC Primary

Addresses

Primary practice location

8262 Market St Ste 103
Wilmington, NC 28411-9681

Mailing address

8262 Market St Ste 103
Wilmington, NC 28411-9681
Phone (910) 686-3396

Other identifiers 1

IdentifierTypeStateIssuer
89093RUMedicaidNC

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
I20040510000908 NC Practitioner - Optometry 6103815675 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1904NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bladen Eye Center OD PLLC Optometrist CurrentSince Jul 14, 2016 Accepting new patients
Dr. Christopher J. Moshoures Optometrist PA Optometrist PastSince Feb 1, 1994 Accepting new patients
Wilmington Eye, P.a. Past Accepting new patients
Wilmington Eye, P.a. PastSince Jul 14, 2016 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 106998@visionworks.emadirect.md
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348531200000",
    "number": "1699866145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8262 MARKET ST STE 103",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284119681",
            "telephone_number": "910-686-3396",
            "fax_number": "910-686-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8262 MARKET ST STE 103",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284119681",
            "telephone_number": "910-686-3396",
            "fax_number": "910-686-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "JASON",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2012-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89093RU",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.