=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225993280
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEVON HENDRIX CMA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2025
-----------------------------------------------------
Last Update Date | 12/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 361 OLIVER ST NW APT 1
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30314-3267
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-971-8584
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 361 OLIVER ST NW APT 1
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30314-3267
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-971-8584
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number | 919253
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------