Active NPI
Samuel Henderson, M.D.
- Family Medicine Physician
- Columbia, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD2020-0367
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Meharry Medical College School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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
- Prisma Health Baptist
- Prisma Health Baptist Parkridge
- Prisma Health Tuomey Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prisma Health Medical Group-Midlands | Family Medicine | Current | Accepting new patients |
| Psychplus Medical Associates, PLLC | Family Medicine | Current | Accepting new patients |
| Southwest Medical Associates, LLC | Family Medicine | Current | Accepting new patients |
| Psychiatry of Texas PLLC | Family Medicine | Current | Accepting new patients |
| Prisma Health Medical Group-Midlands | Family Medicine | Current | Accepting new patients |
| Prisma Health Medical Group-Midlands | Current | Accepting new patients | |
| Southwest Medical Associates, LLC | Family Medicine | Current | 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
- shenderson292200@ahs.direct-ci.com
- 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.
-
- Multi-Specialty Clinic/Center
- Columbia, SC
- NPI 1275988321
Family Medicine
-
- General Practice Physician
- Albuquerque, NM
- NPI 1164491072
Family Medicine
-
- Psychiatry Physician
- Greenville, SC
- NPI 1942164157
-
- Family Medicine Physician
- Sumter, SC
- NPI 1871080283
-
- Durable Medical Equipment & Medical Supplies
- Columbia, SC
- NPI 1881469856
-
- Rural Health Clinic/Center
- Roswell, NM
- NPI 1578255253
Family Medicine
Hospital & facility affiliations 11
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Geriatric Medicine (Internal Medicine) Physician
- Columbia, SC
- NPI 1962471946
Hospital
-
- General Acute Care Hospital
- Columbia, SC
- NPI 1033889795
-
- General Acute Care Hospital
- Columbia, SC
- NPI 1154197846
-
- General Acute Care Hospital
- Columbia, SC
- NPI 1154373843
-
- General Acute Care Hospital
- Coulmbia, SC
- NPI 1154432458
-
- General Acute Care Hospital
- Columbia, SC
- NPI 1205889458
-
- General Acute Care Hospital
- Columbia, SC
- NPI 1306623137
-
- General Acute Care Hospital
- Sumter, SC
- NPI 1326043548
-
- General Acute Care Hospital
- Columbia, SC
- NPI 1396524104
-
- General Acute Care Hospital
- Columbia, SC
- NPI 1508554452
-
- General Acute Care Hospital
- Columbia, SC
- NPI 1811237985
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; 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.