Healthcare Provider Details

I. General information

NPI: 1023831781
Provider Name (Legal Business Name): SHAYLI MARTIN HENDRIX PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2024
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 STANTONSBURG RD
GREENVILLE NC
27834-2818
US

IV. Provider business mailing address

2101 W ARLINGTON BLVD STE 210
GREENVILLE NC
27834-5758
US

V. Phone/Fax

Practice location:
  • Phone: 252-847-4100
  • Fax: 252-931-7694
Mailing address:
  • Phone: 252-752-5000
  • Fax: 252-931-7694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-16334
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: