George Cleveland Henderson Jr.

Primary specialty

Meals ProviderTaxonomy code 174200000X

License

FS-103770 Issued in DC

Practice address

900 G St NE Apt 502
Washington, DC 20002-7414

Phone

(856) 895-1535

NPI assigned

Jun 7, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mr. George Cleveland Henderson II Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1717718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1144062530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 G ST NE APT 502",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200027414",
            "telephone_number": "856-895-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 G ST NE APT 502",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200027414",
            "telephone_number": "856-895-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "GEORGE",
        "middle_name": "CLEVELAND",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-07",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": "DC",
            "license": "FS-103770",
            "primary": false
        },
        {
            "code": "374K00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": "DC",
            "license": "FS-103770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GEORGE",
            "last_name": "HENDERSON",
            "middle_name": "CLEVELAND",
            "prefix": "MR.",
            "suffix": "II",
            "credential": "CKM",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Cynthia Locke Henderson, LICSW, LCSW-C
• Darnell Henderson
• Deborah Henderson
• Demetria Henderson
• Frances B Henderson, RN
• Gregory Henderson, O.T.
• Havette Henderson
• India Henderson
• Jacqueline Henderson
• Jeanette Lucille Henderson

• Meals Provider in Washington, DC
• Providers in Washington, DC by specialty
• Meals Provider in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.