Bennett Ellen Hargrove Henderson, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

Q9635 Issued in TX

Practice address

4102 24TH St Ste 406
Lubbock, TX 79410-1804

Phone

(806) 725-5790

Fax

(806) 725-5791

NPI assigned

Jun 5, 2013

Last updated

Apr 30, 2018By 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 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Texas Tech University Health Science Center School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant Medical GroupGroup PAC ID 6901889393, 228 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Covenant Childrens Hospital Hospital, Lubbock, TX, CCN 453306
• Covenant Medical Center Hospital, Lubbock, TX, CCN 450040

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bennett.boyd@direct.myteamcare.com

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.

• Covenant Medical Group

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1376598904

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Obhg Texas Holdings, P.a.

  • Obstetrics & Gynecology Physician
  • Austin, TX
  • NPI 1083917769
  Medicare reassignment NPD
• Covenant Medical Group

  dba Covenant Family Healthcare Center

  • Rural Health Clinic/Center
  • Abernathy, TX
  • NPI 1538412895
  NPD
• Methodist Children's Hospital

  dba Covenant Children's Hospital

  • Children's Hospital
  • Lubbock, TX
  • NPI 1437171568
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Covenant Medical Center

  • General Acute Care Hospital
  • Lubbock, TX
  • NPI 1972517365
  Care Compare affiliation
• Methodist Children's Hospital

  dba Covenant Children's Hospital

  • Children's Hospital
  • Lubbock, TX
  • NPI 1437171568
  Care Compare affiliation

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525046400000",
    "number": "1043658677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101105",
            "telephone_number": "806-725-5844",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 24TH ST STE 406",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101804",
            "telephone_number": "806-725-5790",
            "fax_number": "806-725-5791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "BENNETT",
        "middle_name": "ELLEN HARGROVE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-05",
        "last_updated": "2018-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "Q9635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "8GX035",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX MEDICARE",
            "identifier": "582317YKT8",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373353701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NM CENTENNIAL",
            "identifier": "1043658677",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44159340",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "1043658677",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Payne Hellums, PTA
• Jason Cade Helton, DC
• Keli Joy Hemingway, LCSW
• Hemmo a Bosscher, MD PA
• Kerry Lane Hendershot, MD
• Brennon Gene Henderson
• Richard A Henderson, M.D.
• Tiffany D Henderson, LMT
• Katie L. Hendley, MD
• Susan Singer Hendrick, PH.D.

• Obstetrics & Gynecology Physician in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; 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.