Ethan Henderson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

042.0016380 Issued in VT

Practice address

163 Veterans Dr
White River Junction, VT 05009-7451

Phone

(254) 743-0311

NPI assigned

Apr 11, 2017

Last updated

Apr 10, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1144754615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 261",
            "city": "QUECHEE",
            "state": "VT",
            "postal_code": "050590261",
            "telephone_number": "254-718-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 VETERANS DR",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050097451",
            "telephone_number": "254-743-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ETHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-11",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S2330",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VT",
            "license": "042.0016380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea J Hawryluk, OD
• Rachel Hayes
• Ran He, O.D., M.S.
• Amy Webster Healy, PT
• Julia Pitkin Healy, MSW, LICSW
• Heather Henderson, PHARM.D.
• Suzanne Henderson
• Philip Wesley Hershberger, M.D.
• Karen E Hetrick, CPM, LM
• Millicent Allyn Higgins, LICSW

• Emergency Medicine Physician in White River Junction, VT
• Providers in White River Junction, VT by specialty
• Emergency Medicine Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.