Paul Manning Henderson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

9900871 Issued in NC

Practice address

3320 Executive Dr
Suite 214
Raleigh, NC 27609-7445

Phone

(919) 878-8596

Fax

(919) 878-0744

NPI assigned

Jun 9, 2006

Last updated

Jun 26, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Capital Family Medicine, P.a.

  • Primary Care Clinic/Center
  • Raleigh, NC
  • NPI 1124007620
  Medicare reassignment
• Hendersonville Family Health Center-Psych

  • Family Psychologist
  • Hendersonville, NC
  • NPI 1457537482
  NPD (past)
• North Raleigh Ophthalmology, P.a.

  • Ophthalmology Physician
  • Raleigh, NC
  • NPI 1225195142
  NPD (past)
• Sterling Emergency Services of the Southeast, Inc

  • Emergency Medicine Physician
  • Salisbury, NC
  • NPI 1770541245
  NPD (past)
• TST Medical, P.a.

  • Family Medicine Physician
  • Hendersonville, NC
  • NPI 1053384859
  NPD (past)
• Western Carolina Medical Assoc., Inc.

  • Clinic/Center
  • Hendersonville, NC
  • NPI 1215941679
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1225079254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 EXECUTIVE DR",
            "address_2": "SUITE 214",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097445",
            "telephone_number": "919-878-8596",
            "fax_number": "919-878-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 EXECUTIVE DR",
            "address_2": "SUITE 214",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097445",
            "telephone_number": "919-878-8596",
            "fax_number": "919-878-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "PAUL",
        "middle_name": "MANNING",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9900871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elissa Henderson, ARNP
• Hunter Dean Henderson, PT, DPT
• Jessica Lynn Henderson, D.O.
• John Wesley Henderson II, DO
• Joshua Mark Henderson, PA-C
• Sage Renai Henderson
• Sharon Henderson
• Tassy Henderson, NCC, LCMCHA
• Ashley Whitney Hendricks, AGACNP
• Chanyel Latisha Hendricks, LCSWA

• Family Medicine Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.

Verify at the official NPI Registry.