Active NPI
Alexis Patrice Henderson
- Pain Medicine Physician
- Clearwater, FL
National Provider Identifier
1245431360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine Physician
- License
- ME38866
- Practice address
- 51 S. Main Ave
Suite 318
Clearwater, FL 33765 - Phone
- (727) 420-9433
- NPI assigned
- May 29, 2007
- Last updated
- Sep 16, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pain Medicine Physician | 208VP0000X | ME38866 | FL | Primary |
Addresses
Primary practice location
51 S. Main Ave
Suite 318
Clearwater, FL 33765
Mailing address
51 S Main Ave Ste 318
Clearwater, FL 33765-3934
Phone (727) 572-6261
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170614000672 | FL | Order and Referring Only - Pain Management | 1456539311 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Careservices of Central Florida LLC | Past | Accepting new patients | |
| Pain Care Management of Orlando, LLC | Past | Accepting new patients | |
| SCC Group Inc | Past | Accepting new patients | |
| Mobile Medical Industries Inc | Past | Accepting new patients | |
| Pain Care Management of Clearwater, LLC | Past | Accepting new patients |
Organizations & group practices 5
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.
-
dba AllianceCare
- Primary Care Nurse Practitioner
- Boynton Beach, FL
- NPI 1528019247
-
dba Pain Care of Clearwater
- Pain Clinic/Center
- Clearwater, FL
- NPI 1790094829
-
dba Pain Care First
- Pain Clinic/Center
- Winter Garden, FL
- NPI 1487964524
-
- Chiropractor
- Avon Park, FL
- NPI 1508966532
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568592000000",
"number": "1245431360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 S MAIN AVE STE 318",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337653934",
"telephone_number": "727-572-6261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 S. MAIN AVE",
"address_2": "SUITE 318",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "33765",
"telephone_number": "727-420-9433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "ALEXIS",
"middle_name": "PATRICE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-29",
"last_updated": "2019-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "FL",
"license": "ME38866",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.