Anita Henderson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

10115 Issued in NV

Practice address

7061 Grand Montecito Pkwy
Las Vegas, NV 89149-0287

Phone

(702) 750-3900

Fax

(702) 750-3916

NPI assigned

Feb 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NV, NM2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ahenderson299414@christushealth.direct-ci.net

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.

• Optum Medical Group II Rhodes P C

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1790329407
  Medicare reassignment NPD
• Southwest Medical Associates, Inc

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1659346005
  Medicare reassignment NPD
• St Vincent Hospital

  • Pediatrics Physician
  • Santa Fe, NM
  • NPI 1063367803
  Medicare reassignment
• Optum Medical Group Rhodes P C

  • Anesthesiology Physician
  • Las Vegas, NV
  • NPI 1770556037
  NPD
• St Vincent Hospital

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  NPD
• St. Vincent Hospital

  • Family Medicine Physician
  • Santa Fe, NM
  • NPI 1245438647
  NPD
• St. Vincent Hospital

  • Critical Care Medicine (Internal Medicine) Physician
  • Santa Fe, NM
  • NPI 1568766210
  NPD
• Artesia General Hospital

  • General Acute Care Hospital
  • Artesia, NM
  • NPI 1437286044
  NPD (past)

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392854400000",
    "number": "1144292129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15645",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891145645",
            "telephone_number": "702-242-7308",
            "fax_number": "702-240-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7061 GRAND MONTECITO PKWY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891490287",
            "telephone_number": "702-750-3900",
            "fax_number": "702-750-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ANITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2014-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "10115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3102646",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00054853",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2018546",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ajia Henderson
• Alfred H Henderson III
• Alice Henderson
• Amanda J Henderson, MS, LCPC, LADC
• Andria Henderson, APRN
• Artranesha Henderson
• Ashamii Henderson
• Ashley Henderson
• Ashley Nicole Henderson
• Bertha Henderson

• Pediatrics Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Pediatrics Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.