Individual provider Active NPI

Robert Ellis Henson II, MD

  • Cardiovascular Disease Physician
  • Littleton, CO
National Provider Identifier
1104822121
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
30651 Issued in CO
Practice address
5961 Rain Dance TRL
Littleton, CO 80125-9095
Phone
(720) 255-4134
Fax
(720) 784-6183
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD60700596 WA
Cardiovascular Disease Physician 207RC0000X 30651 CO Primary

Addresses

Primary practice location

5961 Rain Dance TRL
Littleton, CO 80125-9095

Mailing address

5961 Rain Dance TRL
Littleton, CO 80125-9095
Phone (720) 255-4134

Other identifiers 1

IdentifierTypeStateIssuer
1104822121MedicaidWA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3065COMDMental Health Counselor
30651COMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Heart Associates, P.C. Cardiovascular Disease Past Accepting new patients
Cardiovascular Associates PC Cardiovascular Disease PastSince Apr 1, 2008 Accepting new patients
Denver NMR, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rhenson751387@wm.providencedirect.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1104822121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5961 RAIN DANCE TRL",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801259095",
            "telephone_number": "720-255-4134",
            "fax_number": "720-784-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5961 RAIN DANCE TRL",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801259095",
            "telephone_number": "720-255-4134",
            "fax_number": "720-784-6183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "ROBERT",
        "middle_name": "ELLIS",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD60700596",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "30651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104822121",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.