Bennie S Henderson, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F945 Issued in SC

Practice address

157 B S Greenwood Ave Ext
Ware Shoals, SC 29692

Phone

(864) 456-3447

Fax

(864) 725-4979

NPI assigned

Aug 7, 2006

Last updated

Apr 29, 2009By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Self Medical Group

  • Family Medicine Physician
  • Greenwood, SC
  • NPI 1528380086
  NPD (past)
• Self Medical Group

  • Surgery Physician
  • Greenwood, SC
  • NPI 1982836847
  NPD (past)

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240963200000",
    "number": "1043229982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 B S GREENWOOD AVE EXT",
            "city": "WARE SHOALS",
            "state": "SC",
            "postal_code": "29692",
            "telephone_number": "864-456-3447",
            "fax_number": "864-725-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 B S GREENWOOD AVE EXT",
            "city": "WARE SHOALS",
            "state": "SC",
            "postal_code": "29692",
            "telephone_number": "864-456-3447",
            "fax_number": "864-725-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "BENNIE",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2009-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "F945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0089",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Dyal, LISW-CP
• Parker Edison, MD
• Kathleen Dudasko Frances
• Harmony Residential Care Center, LLC (Ware Shoals Assisted Living Facility)
• Healthstat Onsite Clinic MVM Ware Shoals
• Pamela J Knight, LPN II
• KP and Rd LLC (Ware Shoals Pharmacy)
• Jessica Lynn Maffett, NP
• Kimberly R McClain, R.N.
• Park Pharmacy, Inc

• Family Nurse Practitioner in Ware Shoals, SC
• Providers in Ware Shoals, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; 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.