Individual provider Active NPI

Maegan Danielle Henderson, FNP

  • Family Nurse Practitioner
  • Richardson, TX
National Provider Identifier
1063981074
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP139953 Issued in TX
Practice address
800 W Renner Rd Apt 3816
Richardson, TX 75080-1050
Phone
(214) 603-2191
NPI assigned
Nov 19, 2018
Last updated
Jul 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 773972 TX
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X AP139953 TX Primary

Addresses

Primary practice location

800 W Renner Rd Apt 3816
Richardson, TX 75080-1050

Mailing address

800 W Renner Rd Apt 3816
Richardson, TX 75080-1050
Phone (214) 603-2191

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190717001426 TX Practitioner - Nurse Practitioner 4981939618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.54 of 100Reported as group
Quality
72.94
Improvement activities
40
Cost
48.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
773972TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Med Management Associates Single Specialty CurrentSince Jul 10, 2019 Accepting new patients
Precise Personalized Care Hospice LLC Single Specialty PastSince Mar 1, 2020 Accepting new patients

Locations

1350 Main St
Frisco, TX 75033
Phone (214) 705-9108

4006 Vista Rd
Pasadena, TX 77504
Phone (713) 943-1592

7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472

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.

NPI Registry JSON

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

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1063981074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W RENNER RD APT 3816",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750801050",
            "telephone_number": "214-603-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W RENNER RD APT 3816",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750801050",
            "telephone_number": "214-603-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MAEGAN",
        "middle_name": "DANIELLE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-19",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "773972",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.