Individual provider Active NPI

Richard Hendrick, MD

  • Internal Medicine Physician
  • Tupelo, MS
National Provider Identifier
1770559841
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
07991 Issued in MS
Practice address
845 S Madison St
Tupelo, MS 38801-4905
Phone
(662) 377-5930
Fax
(662) 377-5085
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 07991 MS Primary

Addresses

Primary practice location

845 S Madison St
Tupelo, MS 38801-4905

Mailing address

845 S Madison St
Tupelo, MS 38801-4905
Phone (662) 377-5930

Other identifiers 1

IdentifierTypeStateIssuer
00115114MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20100518000132 MS Practitioner - HospitalistPractitioner - Internal Medicine 0042348724 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
07991MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Inc Current Accepting new patients
Comprehensive Hospitalists of Ms, LLC CurrentSince Apr 19, 2017 Accepting new patients
Pontotoc Health Services, Inc. CurrentSince Feb 21, 2017 Accepting new patients
Comprehensive Hospitalists of Ms, LLC Current Accepting new patients
Pontotoc Health Services, Inc. CurrentSince Feb 21, 2017 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Center, Inc. CurrentSince Oct 1, 2015 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Oct 1, 2015 Accepting new patients

Locations

1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111

1970 Hospital Dr
Clarksdale, MS 38614
Phone (662) 624-3185

176 S Main St
Pontotoc, MS 38863
Phone (601) 489-5510

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

845 S Madison St
Tupelo, MS 38801
Phone (601) 790-5025

Interoperability endpoints

  • Direct secure messaging: richardhendrick@nmhs.medalliesdirect.net

Organizations & group practices 8

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1770559841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 S MADISON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014905",
            "telephone_number": "662-377-5930",
            "fax_number": "662-377-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 S MADISON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014905",
            "telephone_number": "662-377-5930",
            "fax_number": "662-377-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICK",
        "first_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "07991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115114",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.