Organization Active NPI

Henderson Eye Center P C

  • Optometrist
  • Springfield, IL
National Provider Identifier
1295802981
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-009151 Issued in IL
Legal business name
HENDERSON EYE CENTER P C
Practice address
2709 S Koke Mill Rd
Springfield, IL 62711
Phone
(217) 698-9477
Fax
(217) 698-9474
NPI assigned
Nov 29, 2006
Last updated
Dec 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Authorized official

Name
Dorsey Henderson
Title
Manager
Phone
(217) 698-9477

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 046-009151 IL Primary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 046008041 IL
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 036-042254 IL

Addresses

Primary practice location

2709 S Koke Mill Rd
Springfield, IL 62711

Mailing address

2709 S Koke Mill Rd
Springfield, IL 62711
Phone (217) 698-9477

Other names 1

  • henderson & posegate eye center Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050307000306 IL Part B Supplier - Clinic/Group Practice 4789638354 Receives reassigned benefits from 2 practitioners
Practice locations: Springfield, IL

National Provider Directory

National Provider Directory

Locations

3330 Ginger Creek Dr
Ste C
Springfield, IL 62711
Phone (217) 698-9477

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764892800000",
    "number": "1295802981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 S KOKE MILL RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62711",
            "telephone_number": "217-698-9477",
            "fax_number": "217-698-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 S KOKE MILL RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62711",
            "telephone_number": "217-698-9477",
            "fax_number": "217-698-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON EYE CENTER P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "DORSEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "217-698-9477"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009151",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008041",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036-042254",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "henderson & posegate eye center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "henderson & posegate eye center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.