Luke Butler Henderson, D.O.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

DO203696 Issued in OR

Practice address

653 W 8TH St
Jacksonville, FL 32209-6511

Phone

(904) 244-3903

NPI assigned

Apr 9, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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 1

Specialty

Cardiovascular Disease (Cardiology)Also: General Surgery

Education

Arizona College of Osteopathic Medicine Mid Western University, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

PeacehealthGroup PAC ID 8527016039, 200 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102
• Mercy Medical Center Hospital, Roseburg, OR, CCN 380027
• Peace Harbor Medical Center Hospital, Florence, OR, CCN 381316
• Bay Area Hospital Hospital, Coos Bay, OR, CCN 380090

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lhenderson489284@direct.peacehealth.org

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.

• Peacehealth

  • Hospitalist Physician
  • Springfield, OR
  • NPI 1740223874

  Surgery

  Medicare reassignment Care Compare group NPD
• Peacehealth

  • General Acute Care Hospital
  • Springfield, OR
  • NPI 1083888515
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bay Area Hospital District

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Care Compare affiliation
• Commonspirit Oregon

  • General Acute Care Hospital
  • Roseburg, OR
  • NPI 1477590198
  Care Compare affiliation
• Peacehealth

  • General Acute Care Hospital
  • Springfield, OR
  • NPI 1083888515
  Care Compare affiliation
• Peacehealth

  • Psychiatric Hospital Unit
  • Eugene, OR
  • NPI 1568236974
  Care Compare affiliation
• Peacehealth

  • Critical Access Hospital
  • Florence, OR
  • NPI 1578552402
  Care Compare affiliation

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1194144832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-3903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3311 Riverbend Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974778800",
            "country_code": "US",
            "telephone_number": "541-222-3531",
            "fax_number": "541-222-2843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "LUKE",
        "middle_name": "BUTLER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "DO203696",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OR",
            "license": "DO203696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Ray Henderson, DO
• Jacqueline Henderson
• Jessica L Henderson, MSW
• Jimmy Henderson
• Kamiyah Nadine Henderson
• Meesha Prakash Henderson, LMHC
• Megan Henderson, PHARMD
• Natasha Nicole Henderson, ARNP
• Randal Hollis Henderson, MD
• Skylar Henderson

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.
• 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.

Verify at the official NPI Registry.