Andrew Henderson, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA26896 Issued in FL

Practice address

1851 Elkcam Blvd
Deltona, FL 32725-3922

Phone

(706) 888-4647

NPI assigned

May 28, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1033776869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 ELKCAM BLVD",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327253922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 ELKCAM BLVD",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327253922",
            "telephone_number": "706-888-4647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 E Howry Ave",
            "address_purpose": "LOCATION",
            "city": "Deland",
            "state": "FL",
            "postal_code": "327245400",
            "country_code": "US",
            "telephone_number": "386-822-6900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ANDREW",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-28",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA26896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Britney M Hatcher
• Jaclyn Gossman Hauge, L.M., C.P.M
• Andrew Hayden, MD
• Lezlie Hayward, LPN
• Head Over Heart Counseling Services, LLC
• Henderson'S Foster Care Home, Inc.
• Novella Henry
• Ronald Henry, RPH
• Stephen Craig Henry II, D.C.
• Yurisandra Hernandez Morales

• Physical Therapy Assistant in Deltona, FL
• Providers in Deltona, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.