Kodi Nicole Hendrix, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1208 Hickory Blvd SW Ste 102
Lenoir, NC 28645-6461

Phone

(828) 991-4660

Fax

(991) 465-9828

NPI assigned

Nov 23, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kodi Nicole Ethridge Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blue Ridge Healthcare Medical Group IncGroup PAC ID 9436159712, 222 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Caldwell Memorial Hospital Hospital, Lenoir, NC, CCN 340041
• Blue Ridge Healthcare Hospitals, Inc Hospital, Morganton, NC, CCN 340075

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kethridge534900@direct.unc.nchie.net

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.

• Blue Ridge Healthcare Medical Group, Inc.

  • Obstetrics & Gynecology Physician
  • Connelly Springs, NC
  • NPI 1467993931
  Medicare reassignment Care Compare group
• Blue Ridge Healthcare Medical Group, Inc.

  • Physical Therapist
  • Marion, NC
  • NPI 1245728864
  NPD
• Blue Ridge Healthcare Medical Group, Inc.

  • Internal Medicine Physician
  • Morganton, NC
  • NPI 1578424685
  NPD
• Blue Ridge Healthcare Medical Group, Inc.

  • Family Medicine Physician
  • Marion, NC
  • NPI 1801120654
  NPD
• Blue Ridge Healthcare Medical Group, Inc.

  • Family Medicine Physician
  • Marion, NC
  • NPI 1679166821
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Blue Ridge Healthcare Hospitals, Inc.

  • General Acute Care Hospital
  • Rutherford College, NC
  • NPI 1306821798
  Care Compare affiliation
• Blue Ridge Healthcare Hospitals, Inc.

  • Hematology & Oncology Physician
  • Morganton, NC
  • NPI 1417000837

  Hospital

  Care Compare affiliation
• Blue Ridge Healthcare Hospitals, Inc.

  • Hematology & Oncology Physician
  • Valdese, NC
  • NPI 1487707964

  Hospital

  Care Compare affiliation
• Blue Ridge Healthcare Hospitals, Inc.

  • General Acute Care Hospital
  • Morganton, NC
  • NPI 1700860491
  Care Compare affiliation
• Caldwell Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Lenoir, NC
  • NPI 1114974029
  Care Compare affiliation

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

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1912440900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 HICKORY BLVD SW STE 102",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286456461",
            "telephone_number": "828-991-4660",
            "fax_number": "828-991-4659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 HICKORY BLVD SW STE 102",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286456461",
            "telephone_number": "828-991-4660",
            "fax_number": "991-465-9828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 Malcolm Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Connelly Springs",
            "state": "NC",
            "postal_code": "286128079",
            "country_code": "US",
            "telephone_number": "828-874-4600",
            "fax_number": "828-874-8900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2293 Sugar Hill Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "NC",
            "postal_code": "287527787",
            "country_code": "US",
            "telephone_number": "828-652-8727",
            "fax_number": "828-652-8793",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "695 W Fleming Dr",
            "address_purpose": "LOCATION",
            "city": "Morganton",
            "state": "NC",
            "postal_code": "286554450",
            "country_code": "US",
            "telephone_number": "828-580-3278",
            "fax_number": "828-580-3279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "KODI",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-23",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KODI",
            "last_name": "ETHRIDGE",
            "middle_name": "NICOLE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Lenoir, NC
• Providers in Lenoir, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.