Individual provider Active NPI

Leyla M Henderson

  • Infusion Therapy Registered Nurse
  • Laurel, MD
National Provider Identifier
1033605753
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Registered NurseTaxonomy code 163WI0500X
License
R221590 Issued in MD
Practice address
14502 Greenview Dr Ste 360
Laurel, MD 20708-4232
Phone
(240) 720-7197
NPI assigned
Jul 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN1014471 DC
Infusion Therapy Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WI0500X R221590 MD Primary

Addresses

Primary practice location

14502 Greenview Dr Ste 360
Laurel, MD 20708-4232

Mailing address

14502 Greenview Dr Ste 360
Laurel, MD 20708-4232
Phone (240) 720-7197

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN1014471DCMDRegistered Nurse
R221590MDMDInfusion Therapy Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Active Infusions Inc Single Specialty CurrentSince May 8, 2022 Accepting new patients

Locations

14502 Greenview Dr
Ste 360
Laurel, MD 20708
Phone (240) 200-4464

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1033605753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14502 GREENVIEW DR STE 360",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207084232",
            "telephone_number": "240-720-7197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14502 GREENVIEW DR STE 360",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207084232",
            "telephone_number": "240-720-7197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "LEYLA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1014471",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "MD",
            "license": "R221590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.