Individual provider Active NPI

James Arthur Henderson, M.D.

  • Family Medicine Physician
  • Nicholasville, KY
National Provider Identifier
1265457907
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19891 Issued in KY
Practice address
110 Village Pkwy
Nicholasville, KY 40356-2327
Phone
(859) 887-2484
Fax
(859) 885-8448
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19891 KY Primary

Addresses

Primary practice location

110 Village Pkwy
Nicholasville, KY 40356-2327

Mailing address

110 Village Pkwy
Nicholasville, KY 40356-2327
Phone (859) 887-2484

Other identifiers 4

IdentifierTypeStateIssuer
4000501OtherKYMEDICARE LAB GRP
CB5773OtherGARR MEDICARE GRP
37903705OtherKYMEDICAID LAB GRP
64198914MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19891KYMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1265457907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 VILLAGE PKWY",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403562327",
            "telephone_number": "859-887-2484",
            "fax_number": "859-885-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 VILLAGE PKWY",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403562327",
            "telephone_number": "859-887-2484",
            "fax_number": "859-885-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JAMES",
        "middle_name": "ARTHUR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "19891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LAB GRP",
            "identifier": "4000501",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GRP",
            "identifier": "CB5773",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID LAB GRP",
            "identifier": "37903705",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64198914",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nicholasville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; 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.