Individual provider Active NPI

Adina H Henderson, NP

  • Nurse Practitioner
  • Springfield, OR
National Provider Identifier
1063150704
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
202207983NP-PP Issued in OR
Practice address
1435 G St
Springfield, OR 97477-4113
Phone
(541) 735-9420
Fax
(541) 747-9870
NPI assigned
May 23, 2022
Last updated
Jul 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 202207983NP-PP OR Primary
Family Nurse Practitioner 363LF0000X 202207983NP-PP OR
Family Nurse Practitioner 363LF0000X 2018035089 MO

Addresses

Primary practice location

1435 G St
Springfield, OR 97477-4113

Mailing address

PO Box 163
Springfield, OR 97477-0024
Phone (541) 735-9420

Other practice location 1

1650 Chambers St
Eugene, OR 97402-3636
Phone (541) 686-1711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220713003397 OR Practitioner - Nurse Practitioner 1355722968 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
G Street Integrated HealthGroup PAC ID 6800126145, 22 clinicians

Practice addresses (Care Compare)

1435 G St
Springfield, OR 97477-4113
Phone (541) 735-9420

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2018035089MOMDFamily Nurse Practitioner
202207983NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
G Street Integrated Health CurrentSince Apr 28, 2025 Accepting new patients
Oregon Healthcare Resources, LLC CurrentSince Jun 23, 2022 Accepting new patients

Locations

1650 Chambers St
Eugene, OR 97402
Phone (541) 636-9015

1435 G St
Springfield, OR 97477
Phone (541) 514-5213

2000 N 19th St
Springfield, OR 97477
Phone (541) 284-1694

87983 Territorial Rd
Veneta, OR 97487
Phone (541) 935-2200

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1063150704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 163",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974770024",
            "telephone_number": "541-735-9420",
            "fax_number": "541-747-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 G ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774113",
            "telephone_number": "541-735-9420",
            "fax_number": "541-747-9870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Chambers St",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974023636",
            "country_code": "US",
            "telephone_number": "541-686-1711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ADINA",
        "middle_name": "H",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "202207983NP-PP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202207983NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018035089",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.