Kamal Hanee Henderson, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

201400774 Issued in NC

Practice address

186 Kimel Park Dr
Winston Salem, NC 27103-6946

Phone

(336) 277-2000

Fax

(336) 277-2050

NPI assigned

Jun 20, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

University of Alabama School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Moses H Cone Memorial Hospital Operating CorporationGroup PAC ID 6204744600, 724 clinicians

Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Salem Hospital Hospital, Salem, OR, CCN 380051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
• TN PPO C-SNP
• devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
• devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1
• TN PPO

Interoperability endpoints

• Direct secure messaging: khenderson202165@direct.novanthealth.org
• Direct secure messaging: khenderson407397@direct.salemhealth.org

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.

• The Moses H. Cone Memorial Hospital Operating Corporation

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1013265909
  Medicare reassignment Care Compare group NPD
• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Medicare reassignment Care Compare group NPD
• Novant Health Ballantyne Medical Center LLC

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
  • NPI 1760190607
  Medicare reassignment NPD
• Salem Health West Valley

  • Critical Access Hospital
  • Dallas, OR
  • NPI 1245237486
  Medicare reassignment
• Forsyth Memorial Hospital Inc

  • Cardiovascular Disease Physician
  • Winston Salem, NC
  • NPI 1114200771
  NPD
• Forsyth Memorial Hospital, Inc.

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874
  NPD
• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  NPD
• Novant Health Medical Group, LLC

  • Cardiovascular Disease Physician
  • Greensboro, NC
  • NPI 1568973360
  NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1356372064

  Hospitalist

  NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  • Community/Retail Pharmacy
  • Eden, NC
  • NPI 1861222507
  NPD
• Salem Health

  • Durable Medical Equipment & Medical Supplies
  • Keizer, OR
  • NPI 1487434775
  NPD

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

• Salem Health

  • General Acute Care Hospital
  • Salem, OR
  • NPI 1265431829
  Care Compare affiliation

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

{
    "created_epoch": "1276992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1003137407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-277-2000",
            "fax_number": "336-277-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 KIMEL PARK DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036946",
            "telephone_number": "336-277-2000",
            "fax_number": "336-277-2050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Barnes Jewish Hospital Plz",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101003",
            "country_code": "US",
            "telephone_number": "314-362-1700",
            "fax_number": "314-362-9878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 Wheeling St",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800457211",
            "country_code": "US",
            "telephone_number": "303-399-8020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KAMAL",
        "middle_name": "HANEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-20",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "201400774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula A Henao, DDS
• Andrew Scott Henderson, PA-C
• Brittany Henderson
• Emily Kaitlin Henderson
• Jeffrey Harris Henderson, M.D.
• Katherine Beier Henderson
• Leah A Henderson, NA I, COTA/L
• Michaela Simone Henderson, MS, LCMHCA, NCC
• Rebecca Myer Henderson, MD PHD
• Robert Andrew Henderson

• Cardiovascular Disease Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Cardiovascular Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.