Cathy A Henderson, ARNP, MSN, PCCN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN9295968 Issued in FL

Practice address

121 W Macclenny Ave
Macclenny, FL 32063-2029

Phone

(866) 389-2727

NPI assigned

Nov 13, 2018

Last updated

Oct 21, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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 FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

59.59 of 100Reported as apm

Quality

59.93

Promoting interoperability

0

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• University of Florida Jacksonville Physicians Inc

  • Diagnostic Radiology Physician
  • Jacksonville, FL
  • NPI 1326208695
  Medicare reassignment NPD
• University of Florida Jacksonville Physicians Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1487814752
  Medicare reassignment NPD
• University of Florida Jacksonville Physicians, Inc.

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1235398983
  NPD
• University of Florida Jacksonville Physicians, Inc.

  dba UF Health Imaging Center-Baymeadows

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD
• University of Florida Jacksonville Physicians, Inc.

  • Family Medicine Physician
  • Yulee, FL
  • NPI 1518126168
  NPD (past)

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1225507874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W MACCLENNY AVE",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632029",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W MACCLENNY AVE",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632029",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6142 Collins Rd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322445806",
            "country_code": "US",
            "telephone_number": "904-778-3200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 Medical Center Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Hardeeville",
            "state": "SC",
            "postal_code": "299273450",
            "country_code": "US",
            "telephone_number": "843-645-4680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8 Hospital Center Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Hilton Head Island",
            "state": "SC",
            "postal_code": "299268701",
            "country_code": "US",
            "telephone_number": "843-686-0920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "CATHY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "ARNP, MSN, PCCN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9295968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Hardin, DO
• Permeriea Harris-Agyeman
• Amy Michelle Harvey, MSN, APRN, FNP-C
• Linda Louise Heilman, ARNP
• Delaney Helms
• Kammi Mignon Henderson, PHARM.D.
• Heritage Wellness Center, LLC
• Trevor D Hicks, APRN
• Cam Hoang, M.D
• Holiday CVS LLC (CVS Pharmacy #07980)

• Family Nurse Practitioner in Macclenny, FL
• Providers in Macclenny, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.