Individual provider Active NPI

Anita Yuan-Yi Henderson, PHARMD

  • Ambulatory Care Pharmacist
  • Perry Point, MD
National Provider Identifier
1053789453
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
23674 Issued in MD
Practice address
Perry Point VA Medical Center
119
Perry Point, MD 21092
Phone
(410) 642-2411
Fax
(410) 642-1122
NPI assigned
Sep 2, 2015
Last updated
Jun 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Pharmacist 1835P2201X 23674 MD Primary
Pharmacist 183500000X 26026237A IN

Addresses

Primary practice location

Perry Point VA Medical Center
119
Perry Point, MD 21092

Mailing address

Perry Point VA Medical Center
Perry Point, MD 21092
Phone (410) 642-2411

Other names 1

  • Anita Wong Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
26026237AINMDPharmacist
23674MDMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1053789453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PERRY POINT VA MEDICAL CENTER",
            "city": "PERRY POINT",
            "state": "MD",
            "postal_code": "21092",
            "telephone_number": "410-642-2411",
            "fax_number": "410-642-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PERRY POINT VA MEDICAL CENTER",
            "address_2": "119",
            "city": "PERRY POINT",
            "state": "MD",
            "postal_code": "21092",
            "telephone_number": "410-642-2411",
            "fax_number": "410-642-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ANITA",
        "middle_name": "YUAN-YI",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-02",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "MD",
            "license": "23674",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26026237A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANITA",
            "last_name": "WONG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Perry Point, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.