Active NPI
Xavier Henderson, DPT
- Physical Therapist
- Lawrence, KS
National Provider Identifier
1184576282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1108092
- Practice address
- 2540 Iowa St
Lawrence, KS 66046-5776 - Phone
- (785) 371-9721
- Fax
- (785) 592-6900
- NPI assigned
- Feb 11, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1108092 | KS | Primary |
Addresses
Primary practice location
2540 Iowa St
Lawrence, KS 66046-5776
Mailing address
2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-6200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2540 Iowa St
Suite a
Lawrence, KS 66046-5753
Phone (785) 371-9721
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1108092 | KS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athletico LTD | Multi-Specialty | Current | Accepting new patients |
| Athletico LTD | Multi-Specialty | Current | Accepting new patients |
Locations
2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250
2540 Iowa St
Ste A
Lawrence, KS 66046
Phone (785) 371-9721
9544 Antioch Rd
Overland Park, KS 66212
Phone (913) 396-6756
Organizations & group practices 2
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": "1770768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770768000000",
"number": "1184576282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2122 YORK RD STE 300",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605231925",
"telephone_number": "630-575-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2540 IOWA ST",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660465776",
"telephone_number": "785-371-9721",
"fax_number": "785-592-6900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "XAVIER",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-02-11",
"last_updated": "2026-02-11",
"certification_date": "2026-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "KS",
"license": "1108092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lawrence, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.