Elizabeth Burford Henderson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9113087 Issued in FL

Practice address

1600 SW Archer Rd
Gainesville, FL 32610-3003

Phone

(352) 273-5501

NPI assigned

Dec 16, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Roller Weight Loss Institute, Inc.Group PAC ID 0446398770, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Roller Weight Loss Institute,Inc.

  • Specialist
  • Fayetteville, AR
  • NPI 1073743399
  Medicare reassignment Care Compare group
• Roller Weight Loss Institute Inc

  • Surgery Physician
  • Tulsa, OK
  • NPI 1912446741
  NPD

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1003387333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100129",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100129",
            "telephone_number": "352-273-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-273-5501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "629 Wilder Pl",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711044325",
            "country_code": "US",
            "telephone_number": "318-364-7415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2751 Albert L Bicknell Dr Fl 4",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "71103",
            "country_code": "US",
            "telephone_number": "318-212-8350",
            "fax_number": "318-212-8356",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2751 Albert L Bicknell Dr Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711033939",
            "country_code": "US",
            "telephone_number": "318-212-8350",
            "fax_number": "318-212-8356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ELIZABETH",
        "middle_name": "BURFORD",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "310462",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henderson Chiropractic Center
• Amanda Henderson, MBA
• Andrece Henderson
• Brandi Henderson, BCBA
• Douglas Stuart Henderson, DC
• Heather Henderson
• Jamira S Henderson
• Joseph Smith Henderson, LMT
• Kerry Henderson, MD
• Lalitha Pauliah Henderson, AUD

• Physician Assistant in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.