Provider Demographics
NPI:1710960109
Name:HENDRIX, JAMES GRANT (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:GRANT
Last Name:HENDRIX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 PARK RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3239
Mailing Address - Country:US
Mailing Address - Phone:704-323-2000
Mailing Address - Fax:
Practice Address - Street 1:354 COPPERFIELD BLVD NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2402
Practice Address - Country:US
Practice Address - Phone:704-323-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35365207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1576561005OtherCIGNA HEALTHCARE
340645OtherONE HEALTH PLAN
45728OtherMEDCOST
9016OtherPARTNERS MEDICARE
SCQ35365Medicaid
0941551OtherUNITED HEALTHCARE
200036694OtherRAILROAD MEDICARE
530003OtherPRINCIPAL HEALTHCARE
4253484OtherAETNA HMO PPO
2069444OtherAETNA US HEALTHCARE
41321OtherBCBS OF NC
NC8941321Medicaid
4253484OtherAETNA HMO PPO
NC2173069AMedicare PIN
200036694OtherRAILROAD MEDICARE