Organization Active NPI

Henderson Clinic for Women PA

  • Legal Medicine
  • Henderson, NC
National Provider Identifier
1104829183
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
39877 Issued in NC
Legal business name
HENDERSON CLINIC FOR WOMEN PA
Practice address
511 Ruin Creek Rd
Ste 101
Henderson, NC 27536-5919
Phone
(252) 492-8576
Fax
(252) 492-7464
NPI assigned
May 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Nancy P King
Title
Office Manager
Phone
(252) 492-8576

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193400000X SINGLE SPECIALTY GROUP 173000000X 39877 NC Primary

Addresses

Primary practice location

511 Ruin Creek Rd
Ste 101
Henderson, NC 27536-5919

Mailing address

511 Ruin Creek Rd
Ste 101
Henderson, NC 27536-5919
Phone (252) 492-8576

Other identifiers 3

IdentifierTypeStateIssuer
89-01757MedicaidNC
7808539OtherNCAETNA GROUP ID
16402OtherNCWELLPATH GROUP ID

Other names 1

  • Henderson Clinic For Women Doing business as

National Provider Directory

National Provider Directory

Locations

511 Ruin Creek Rd
Ste 101
Henderson, NC 27536
Phone (252) 436-0440

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104829183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 RUIN CREEK RD",
            "address_2": "STE 101",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275365919",
            "telephone_number": "252-492-8576",
            "fax_number": "252-492-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 RUIN CREEK RD",
            "address_2": "STE 101",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275365919",
            "telephone_number": "252-492-8576",
            "fax_number": "252-492-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON CLINIC FOR WOMEN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "252-492-8576",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "NC",
            "license": "39877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89-01757",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GROUP ID",
            "identifier": "7808539",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLPATH GROUP ID",
            "identifier": "16402",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henderson Clinic For Women",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.