Individual provider Active NPI

Curtis W Henderson, D.O.

  • Emergency Medicine Physician
  • Sun City West, AZ
National Provider Identifier
1114977154
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
3385 Issued in AZ
Practice address
14502 W Meeker Blvd
Sun City West, AZ 85375-5282
Phone
(623) 214-4000
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3385 AZ
Emergency Medicine Physician 207P00000X 3385 AZ Primary

Addresses

Primary practice location

14502 W Meeker Blvd
Sun City West, AZ 85375-5282

Mailing address

2100 Powell St
Suite 900
Emeryville, CA 94608-1826
Phone (510) 350-2600

Other identifiers 1

IdentifierTypeStateIssuer
450437MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060816000591 AZ Practitioner - Emergency Medicine 7911910328 Reassigns benefits to 3 organizations
I20141223001498 CO Practitioner - Emergency MedicinePractitioner - Family Practice 7911910328 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Southwest, PC Emergency Medicine CurrentSince Mar 1, 2007 Accepting new patients
Quantum Healthcare Medical Associates of Arizona, PC Emergency Medicine CurrentSince Jun 26, 2012 Accepting new patients
Emergency Professionals of Colorado, PC Emergency Medicine CurrentSince Sep 1, 2015 Accepting new patients
Emergency Professionals of Colorado, PC Emergency Medicine CurrentSince Sep 1, 2015 Accepting new patients
Emergency Professionals of Colorado, PC Emergency Medicine Past Accepting new patients
Team Physicians of Arizona PC Emergency Medicine Past Accepting new patients
Emergency Professionals of Colorado, PC Emergency Medicine Past Accepting new patients
Emergency Professionals of Colorado, PC Emergency Medicine Past Accepting new patients

Locations

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

4700 Lady Moon Dr
Fort Collins, CO 80528
Phone (970) 521-4600

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

2000 70th Ave
Greeley, CO 80634
Phone (970) 352-7366

2000 Boise Ave
Loveland, CO 80538
Phone (970) 635-4071

615 Fairhurst St
Sterling, CO 80751
Phone (970) 521-0322

Organizations & group practices 9

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1114977154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600",
            "fax_number": "510-879-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14502 W MEEKER BLVD",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755282",
            "telephone_number": "623-214-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "CURTIS",
        "middle_name": "W",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "3385",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "3385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "450437",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

Verify at the official NPI Registry.