Individual provider Active NPI

Jennifer Henson, O.D

  • Optometrist
  • Cordova, TN
National Provider Identifier
1194705608
Registry record updated Jul 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3350 Issued in FL
Practice address
7865 Trinity Rd Ste 104
Cordova, TN 38018-2274
Phone
(901) 753-7100
Fax
(901) 753-3688
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3350 FL Primary

Addresses

Primary practice location

7865 Trinity Rd Ste 104
Cordova, TN 38018-2274

Mailing address

1990 Brooks Bluff CV
Collierville, TN 38017-0854
Phone (757) 469-6367

Other identifiers 1

IdentifierTypeStateIssuer
036614500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230119000607 TN Practitioner - Optometry 8628367331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Eyecare, PLCGroup PAC ID 7810062650, 2 clinicians
Eye Care Associates of Co LLCGroup PAC ID 9537597828, 63 clinicians

Practice addresses (Care Compare)

11860 Cranston Dr
Arlington, TN 38002-4886
Phone (901) 867-5540

7865 Trinity Rd
Suite 104
Cordova, TN 38018-2274
Phone (901) 753-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC3350FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Eyecare, PLC Optometrist CurrentSince Jan 1, 2023 Accepting new patients
Eye Care Associates of Co LLC Optometrist CurrentSince Jul 15, 2026 Accepting new patients
Eye Care Associates of Co LLC Optometrist PastSince Jul 15, 2026 Accepting new patients
Ernst Nicolitz MD PA Past Accepting new patients

Locations

11860 Cranston Dr
Arlington, TN 38002
Phone (901) 867-5540

7865 Trinity Rd
Ste 104
Cordova, TN 38018
Phone (901) 753-7100

4557 Millbranch Rd
Memphis, TN 38116
Phone (901) 346-8222

Organizations & group practices 4

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785024000000",
    "number": "1194705608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 BROOKS BLUFF CV",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380170854",
            "telephone_number": "757-469-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7865 TRINITY RD STE 104",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380182274",
            "telephone_number": "901-753-7100",
            "fax_number": "901-753-3688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2026-07-26",
        "certification_date": "2026-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036614500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

Verify at the official NPI Registry.