Jeffery Leonard Henderson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

15-00238 Issued in KS

Practice address

701 E a Ave
Kingman, KS 67068-1723

Phone

(620) 532-5145

Fax

(620) 532-2586

NPI assigned

May 20, 2006

Sex

Male

Sole proprietor

No

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.

• Kingman Health Clinic, P.a.

  • Family Medicine Physician
  • Kingman, KS
  • NPI 1366450199
  NPD (past)
• Kingman Health Clinic, P.a.

  • Rural Health Clinic/Center
  • Kingman, KS
  • NPI 1821007840
  NPD (past)
• Runway Emergency Physicians LLC

  • Emergency Medicine Physician
  • Wichita, KS
  • NPI 1063751352
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 5, 2014.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1295789584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E A AVE",
            "city": "KINGMAN",
            "state": "KS",
            "postal_code": "670681723",
            "telephone_number": "620-532-5145",
            "fax_number": "620-532-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E A AVE",
            "city": "KINGMAN",
            "state": "KS",
            "postal_code": "670681723",
            "telephone_number": "620-532-5145",
            "fax_number": "620-532-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JEFFERY",
        "middle_name": "LEONARD",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "15-00238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Halderson
• Jannah M Handshy, LMFT
• Rochelle Dawn Harden, AU.D.
• Angela Katherine Hartschen, APRN
• Gregory Edwin Heikes, RPH
• HMS Rehabilitation Inc
• Jessica Marie Holloway, APRN
• Horizons Mental Health Center, Inc.
• Dawna Kay Huhman, ARNP
• Dennis Kalmar, PA-C

• All providers in Kingman, KS
• Medical Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; 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.