Individual provider Active NPI

Samuel Henderson, M.D.

  • Family Medicine Physician
  • Columbia, SC
National Provider Identifier
1043745508
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD2020-0367 Issued in NM
Practice address
14 Richland Medical Park Dr Ste 320
Columbia, SC 29203-6896
Phone
(803) 434-6771
Fax
(803) 434-3955
NPI assigned
Apr 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 93050 SC
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X MD2020-0367 NM Primary

Addresses

Primary practice location

14 Richland Medical Park Dr Ste 320
Columbia, SC 29203-6896

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 695-6697

Other practice location 1

4010 S Mulberry St
Pine Bluff, AR 71603-7000
Phone (870) 541-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200617001822 NM Practitioner - Family Practice 9133541386 Reassigns benefits to 3 organizations
I20241029001019 SC Practitioner - Family PracticePractitioner - Hospitalist 9133541386 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospitalist
Education
Meharry Medical College School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians
Psychplus Medical Associates PLLCGroup PAC ID 2668813460, 42 clinicians

Practice addresses (Care Compare)

14 Richland Medical Park Dr
Suite 320
Columbia, SC 29203-6896
Phone (803) 434-6771

221 Adley Way
Greenville, SC 29607-6511
Phone (832) 869-4818

5000 Cutler Ave NE
Suite a
Albuquerque, NM 87110-4081
Phone 8328694818235

Hospital & facility affiliations

  • Prisma Health Richland Hospital Hospital, Columbia, SC, CCN 420018
  • Prisma Health Baptist Hospital, Columbia, SC, CCN 420086
  • Prisma Health Baptist Parkridge Hospital, Columbia, SC, CCN 420106
  • Prisma Health Tuomey Hospital Hospital, Sumter, SC, CCN 420070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands Family Medicine Current Accepting new patients
Psychplus Medical Associates, PLLC Family Medicine CurrentSince Feb 4, 2026 Accepting new patients
Southwest Medical Associates, LLC Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
Psychiatry of Texas PLLC Family Medicine CurrentSince Feb 4, 2026 Accepting new patients
Prisma Health Medical Group-Midlands Family Medicine CurrentSince Sep 9, 2024 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Sep 9, 2024 Accepting new patients
Southwest Medical Associates, LLC Family Medicine CurrentSince Aug 1, 2020 Accepting new patients

Locations

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

5000 Cutler Ave NE
Ste A
Albuquerque, NM 87110
Phone (505) 227-7434

10101 Lagrima de Oro Rd NE
Albuquerque, NM 87111
Phone (505) 298-1231

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

2300 N Main St
Ste 209
Las Cruces, NM 88001
Phone (575) 525-3980

1510 Whiskey Rd
Ste 2
Aiken, SC 29803

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

Taylor At Marion St
Columbia, SC 29220
Phone (803) 296-3097

14 Richland Medical Park Dr
Ste 320
Columbia, SC 29203
Phone (803) 434-1663

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

221 Adley Way
Greenville, SC 29607
Phone (661) 378-0517

115 N Sumter St
Ste 110
Sumter, SC 29150
Phone (803) 774-5249

Interoperability endpoints

  • Direct secure messaging: shenderson292200@ahs.direct-ci.com
  • Direct secure messaging: shenderson810024@direct.ghs.myhfn.org

Organizations & group practices 8

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1043745508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-695-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK DR STE 320",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036896",
            "telephone_number": "803-434-6771",
            "fax_number": "803-434-3955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4010 S Mulberry St",
            "address_purpose": "LOCATION",
            "city": "Pine Bluff",
            "state": "AR",
            "postal_code": "716037000",
            "country_code": "US",
            "telephone_number": "870-541-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "SAMUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-21",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "93050",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2020-0367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.