Sandra M Henderson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

21628 Issued in TN

Practice address

1627 Old Gray Station Rd
Johnson City, TN 37615-4193

Phone

(423) 282-3376

Fax

(423) 791-8388

NPI assigned

Aug 24, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Nurse Practitioner

Education

East Tennessee State University Quillen College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tricities Skin and Cancer.Group PAC ID 8527031954, 15 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.14 of 100Reported as group

Quality

76.93

Improvement activities

40

Cost

81.22

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shenderson@directaddress.net

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.

• Tricities Skin and Cancer

  • Dermatology Physician
  • Johnson City, TN
  • NPI 1295824415
  Medicare reassignment Care Compare group NPD
• Skinwise PLLC

  • Dermatology Physician
  • Johnson City, TN
  • NPI 1538025135
  NPD

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1033664503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 OLD GRAY STATION RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154193",
            "telephone_number": "423-282-3376",
            "fax_number": "423-791-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 OLD GRAY STATION RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154193",
            "telephone_number": "423-282-3376",
            "fax_number": "423-791-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "SANDRA",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-24",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q044000",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hayley Christian Henderson, MA
• Jesse Henderson, LPC-MHSP
• Jodie Marie Henderson, LPC-MHSP TEMP
• Leandra R Henderson, APN
• Olivia Henderson
• Benjamin Oliver Hendrich
• Benjamin Hendrickson
• Stacey Hendrickson, LCSW
• Richard A Hendrix, RPH
• Sara Hendrix, PHARMD

• Family Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; 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.