Organization Active NPI

Rodney D. Henderson, M.D.

  • Orthopaedic Surgery Physician
  • Yuma, AZ
National Provider Identifier
1013205863
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
44983 Issued in AZ
Legal business name
RODNEY D. HENDERSON, M.D.
Practice address
2851 S Avenue B
Suite 2403
Yuma, AZ 85364-7726
Phone
(928) 726-2990
Fax
(928) 726-0786
NPI assigned
Jul 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2015

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

Authorized official

Name
Dr. Rodney D. Henderson, M.D.NPI 1225035488
Title
Director
Phone
(928) 726-2990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 44983 AZ Primary

Addresses

Primary practice location

2851 S Avenue B
Suite 2403
Yuma, AZ 85364-7726

Mailing address

9187 Clairemont Mesa Blvd
#6733
San Diego, CA 92123-1257
Phone (928) 726-2990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110916000142 AZ Part B Supplier - Clinic/Group Practice 4486825759 Receives reassigned benefits from 2 practitioners
Practice locations: Yuma, AZ

National Provider Directory

National Provider Directory

Locations

2851 S Avenue B
Ste 2403
Yuma, AZ 85364
Phone (928) 726-2990

2281 W 24th St
Ste 1
Yuma, AZ 85364
Phone (928) 276-4293

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431993600000",
    "number": "1013205863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9187 CLAIREMONT MESA BLVD",
            "address_2": "#6733",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231257",
            "telephone_number": "928-726-2990",
            "fax_number": "928-726-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 S AVENUE B",
            "address_2": "SUITE 2403",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647726",
            "telephone_number": "928-726-2990",
            "fax_number": "928-726-0786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODNEY D. HENDERSON, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-14",
        "last_updated": "2015-05-19",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "928-726-2990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "44983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.