Active NPI
Jeffrey Henderson, DPT
- Physical Therapist
- Beaver, PA
National Provider Identifier
1194860171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT017634
- Practice address
- 107 Pinkerton Dr
Beaver, PA 15009-1213 - Phone
- (412) 403-0711
- NPI assigned
- Feb 20, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT017634 | PA | Primary |
| Physical Therapist | 225100000X | PT32765 | CA |
Addresses
Primary practice location
107 Pinkerton Dr
Beaver, PA 15009-1213
Mailing address
107 Pinkerton Dr
Beaver, PA 15009-1213
Phone (412) 403-0711
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT32765 | CA | MD | Physical Therapist |
| PT017634 | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| N&D Health Care Services, Inc. | Current | Accepting new patients | |
| MSJ Healthcare LLC | Current | Accepting new patients | |
| Grandcare San Diego, LLC | Physical Therapist | Current | Accepting new patients |
Organizations & group practices 3
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194860171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 PINKERTON DR",
"city": "BEAVER",
"state": "PA",
"postal_code": "150091213",
"telephone_number": "412-403-0711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 PINKERTON DR",
"city": "BEAVER",
"state": "PA",
"postal_code": "150091213",
"telephone_number": "412-403-0711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "JEFFREY",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT017634",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT32765",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaver, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.