Individual provider Active NPI

Amy N. Hendrix, DO

  • Obstetrics & Gynecology Physician
  • Gallipolis, OH
National Provider Identifier
1720288228
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
34.010204 Issued in OH
Practice address
100 Jackson Pike
Gallipolis, OH 45631-1560
Phone
(855) 446-5937
Fax
(740) 446-5082
NPI assigned
Jul 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2384 WV
Obstetrics & Gynecology Physician 207V00000X 34.010204 OH Primary

Addresses

Primary practice location

100 Jackson Pike
Gallipolis, OH 45631-1560

Mailing address

90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-5381

Other identifiers 5

IdentifierTypeStateIssuer
10122071MedicaidWV
000000432605OtherOHOHIO MEDICAID UNISON
0050884MedicaidOH
0050884OtherOHOHIO MEDICAID MOLINA
310917085257OtherOHOHIO MEDICAID CARESOURCE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amy.hendrix.1@17389.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20110809000707 OH Practitioner - Obstetrics/Gynecology 2264601202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Ohio University, College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holzer Clinic LLCGroup PAC ID 5890606008, 266 clinicians

Practice addresses (Care Compare)

100 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-5050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.27 of 100Reported as group
Quality
68.56
Promoting interoperability
100
Improvement activities
40
Cost
68.7

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2384WVMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
I Path LLC Current Accepting new patients
Holzer Clinic, LLC CurrentSince Aug 29, 2011 Accepting new patients

Locations

100 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5050

90 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5131

Organizations & group practices 2

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.

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": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1720288228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-446-5381",
            "fax_number": "740-446-5082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "855-446-5937",
            "fax_number": "740-446-5082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "AMY",
        "middle_name": "N.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WV",
            "license": "2384",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "34.010204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10122071",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO MEDICAID UNISON",
            "identifier": "000000432605",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050884",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO MEDICAID MOLINA",
            "identifier": "0050884",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO MEDICAID CARESOURCE",
            "identifier": "310917085257",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.hendrix.1@17389.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "100 Jackson Pike",
            "city": "Gallipolis",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456311560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gallipolis, OH

Sources for this page

Verify at the official NPI Registry.