Active NPI
George Patrick Henderson, M.D.
- Otolaryngology Physician
- Southern Pines, NC
National Provider Identifier
1215985957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 14211
- Practice address
- 115 Highland Rd
Southern Pines, NC 28387-5725 - Phone
- (910) 692-7868
- NPI assigned
- May 5, 2006
- Last updated
- Sep 26, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 14211 | NC | Primary |
Addresses
Primary practice location
115 Highland Rd
Southern Pines, NC 28387-5725
Mailing address
115 Highland Rd
Southern Pines, NC 28387-5725
Phone (910) 692-7868
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14211 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222387200000",
"number": "1215985957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 HIGHLAND RD",
"city": "SOUTHERN PINES",
"state": "NC",
"postal_code": "283875725",
"telephone_number": "910-692-7868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 HIGHLAND RD",
"city": "SOUTHERN PINES",
"state": "NC",
"postal_code": "283875725",
"telephone_number": "910-692-7868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "GEORGE",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2008-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NC",
"license": "14211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southern Pines, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.