Active NPI
Kim Henderson
- Registered Nurse
- Stamford, CT
National Provider Identifier
1083024491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 670204-1
- Practice address
- 707 Summer St
Stamford, CT 06901-1026 - Phone
- (203) 653-4700
- NPI assigned
- May 7, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 670204-1 | NY | Primary |
| Registered Nurse | 163W00000X | 110682 | CT |
Addresses
Primary practice location
707 Summer St
Stamford, CT 06901-1026
Mailing address
707 Summer St
Stamford, CT 06901
Phone (203) 653-4700
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110682 | CT | MD | Registered Nurse |
| 670204-1 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399420800000",
"number": "1083024491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 SUMMER ST",
"city": "STAMFORD",
"state": "CT",
"postal_code": "06901",
"telephone_number": "203-653-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 SUMMER ST",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069011026",
"telephone_number": "203-653-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "KIM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-07",
"last_updated": "2014-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "670204-1",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CT",
"license": "110682",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stamford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.