Active NPI
James Arthur Henderson, M.D.
- Family Medicine Physician
- Nicholasville, KY
National Provider Identifier
1265457907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 19891
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4000501 | Other | KY | MEDICARE LAB GRP |
| CB5773 | Other | GA | RR MEDICARE GRP |
| 37903705 | Other | KY | MEDICAID LAB GRP |
| 64198914 | Medicaid | KY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19891 | KY | MD | Family 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.