Kimberly Black Hendrix, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

35366 Issued in NC

Practice address

700 E Morehead St
Ste 300
Charlotte, NC 28202-2742

Phone

(704) 334-7800

Fax

(704) 414-7512

NPI assigned

Jun 24, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

Practice roles

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.

• Charlotte Radiology PA

  • Diagnostic Radiology Physician
  • Charlotte, NC
  • NPI 1003110677
  NPD (past)

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1811993728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST",
            "address_2": "STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022742",
            "telephone_number": "704-334-7800",
            "fax_number": "704-414-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST",
            "address_2": "STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022742",
            "telephone_number": "704-334-7800",
            "fax_number": "704-414-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "KIMBERLY",
        "middle_name": "BLACK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-24",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "37508",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "35366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8941591",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William James Henderson, OD
• Jill Lynne Hendra, DO
• Hendrick Home Care, LLC
• Danielle Nicole Hendrick, MD
• David Keaton Hendrix
• Madeline Claire Hendrix, MD
• Nneka Avery Hendrix, MD
• Shamara Hendry
• Martin McMillan Henegar, MD
• Brant Todd Heniford, MD

• Diagnostic Radiology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Diagnostic Radiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.