Victor R Henderson, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

26987 Issued in AZ

Practice address

2500 E Hunt Dr
Ste H
Show Low, AZ 85901

Phone

(928) 537-6964

Fax

(928) 532-8798

NPI assigned

Sep 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Privia Medical Group Arizona, LLC

  • Neurology Physician
  • Phoenix, AZ
  • NPI 1245876705
  NPD (past)
• Privia Medical Group Arizona, LLC

  • Family Medicine Physician
  • Payson, AZ
  • NPI 1740459700
  NPD (past)
• Privia Medical Group Arizona, LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1760441141
  NPD (past)

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1245225309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 E SHOW LOW LAKE RD",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "85901",
            "telephone_number": "928-537-6978",
            "fax_number": "928-537-4205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E HUNT DR",
            "address_2": "STE H",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "85901",
            "telephone_number": "928-537-6964",
            "fax_number": "928-532-8798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "VICTOR",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "AZ",
            "license": "26987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "440264",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Health Angels Companion Care, Inc. (Health Angels Companion Care)
• Heart Center of Northeastern Arizona, LLC
• Heart Health Care LLC
• Steven W Helland, M.D.
• Helping Life Connect LLC (Leslie Keene, LCSW)
• Christine Henry, MS, CCC-SLP
• Matthew P Hiatt, PHARM D
• Cassie Hiebert, MS
• Janie Hiesirman-Gorak
• Kalandra Hilaire, LAMFT

• Radiation Oncology Physician in Show Low, AZ
• Providers in Show Low, AZ by specialty
• Radiation Oncology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.