Organization Active NPI

Hendersonville Pediatrics, P.a.

  • Specialist
  • Hendersonville, NC
National Provider Identifier
1912966656
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
HENDERSONVILLE PEDIATRICS, P.A.
Practice address
600 Beverly Hanks Ctr
Hendersonville, NC 28792-2305
Phone
(828) 693-3296
Fax
(828) 696-3530
NPI assigned
Mar 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Tamara Hyder
Title
Practice Manager
Phone
(828) 693-3296

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

600 Beverly Hanks Ctr
Hendersonville, NC 28792-2305

Mailing address

600 Beverly Hanks Ctr
Hendersonville, NC 28792-2305
Phone (828) 693-3296

Other identifiers 1

IdentifierTypeStateIssuer
01764MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161108001647 NC Part B Supplier - Clinic/Group Practice 7719266170 Receives reassigned benefits from 1 practitioner
Practice locations: Brevard, NC; Hendersonville, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D0247800Hendersonville Pediatrics - Hendersonville600 Beverly Hanks Center, Hendersonville, NC 28792AccreditationJan 29, 2027

National Provider Directory

National Provider Directory

Locations

159 Medical Park Dr
Ste A
Brevard, NC 28712

157 Medical Park Dr
Ste A
Brevard, NC 28712

157 Medical Park Dr
Bldg 3
Brevard, NC 28712
Phone (828) 884-3440

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912966656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BEVERLY HANKS CTR",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287922305",
            "telephone_number": "828-693-3296",
            "fax_number": "828-696-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BEVERLY HANKS CTR",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287922305",
            "telephone_number": "828-693-3296",
            "fax_number": "828-696-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSONVILLE PEDIATRICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HYDER",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "828-693-3296",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01764",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.