Organization Active NPI

H R Henderson MD P C

  • Psychiatry Physician
  • Eugene, OR
National Provider Identifier
1114125986
Registry record updated Jul 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MDO7996 Issued in OR
Legal business name
H R HENDERSON MD P C
Practice address
66 Club Rd Ste 210
Eugene, OR 97401-2460
Phone
(541) 485-9136
Fax
(541) 343-0058
NPI assigned
Jul 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2015

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

Authorized official

Name
Dr. Hugh Richard Henderson III, M.D.
Title
President
Phone
(541) 485-8136

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X MDO7996 OR Primary

Addresses

Primary practice location

66 Club Rd Ste 210
Eugene, OR 97401-2460

Mailing address

66 Club Rd Ste 210
Eugene, OR 97401-2460
Phone (541) 485-9136

Other identifiers 1

IdentifierTypeStateIssuer
08617-3MedicaidOR

National Provider Directory

National Provider Directory

Locations

66 Club Rd
Ste 210
Eugene, OR 97401
Phone (541) 343-2569

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436832000000",
    "number": "1114125986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 CLUB RD STE 210",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012460",
            "telephone_number": "541-485-9136",
            "fax_number": "541-343-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 CLUB RD STE 210",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012460",
            "telephone_number": "541-485-9136",
            "fax_number": "541-343-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H R HENDERSON MD P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2015-07-14",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "HUGH",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-485-8136",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MDO7996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08617-3",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; 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.