Individual provider Active NPI

John Tyler Henderson, MD

  • Hospitalist Physician
  • Lexington, KY
National Provider Identifier
1245980697
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
61906 Issued in KY
Practice address
900 S. Limestone, CTW 304
Lexington, KY 40536-0293
Phone
(859) 323-6561
NPI assigned
Mar 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 61906 KY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

900 S. Limestone, CTW 304
Lexington, KY 40536-0293

Mailing address

900 S Limestone CTW 304
Lexington, KY 40536-0293

Other practice location 1

800 Rose St
Lexington, KY 40536-0293
Phone (859) 323-6047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20230915001925 KY Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8729442249

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
University of Kentucky College of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

115 Waller Ave
Suite 209
Lexington, KY 40503-1035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
61906KYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1245980697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S LIMESTONE CTW 304",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S. LIMESTONE, CTW 304",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360293",
            "telephone_number": "859-323-6561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Rose St",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360293",
            "country_code": "US",
            "telephone_number": "859-323-6047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JOHN",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "61906",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.