Michael S Henderson OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

879 Issued in SC

Legal business name

MICHAEL S HENDERSON OD PA

Practice address

167 Bluffton Rd Ste F
Bluffton, SC 29910-6228

Phone

(843) 757-7160

Fax

(843) 757-8464

NPI assigned

Jan 7, 2013

Last updated

Jan 7, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Sentman Henderson, OD

Title

Owner

Phone

(843) 757-7160

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357516800000",
    "number": "1033456389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 BLUFFTON RD STE F",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299106228",
            "telephone_number": "843-757-7160",
            "fax_number": "843-757-8464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 BLUFFTON RD STE F",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299106228",
            "telephone_number": "843-757-7160",
            "fax_number": "843-757-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL S HENDERSON OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-01-07",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SENTMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-757-7160",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Bluffton, SC
• Providers in Bluffton, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.