NPIMap

Organization Active NPI

Henderson Vision Center

  • Optometrist
  • Hernando, MS
National Provider Identifier
1306931597
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
741 Issued in MS
Legal business name
HENDERSON VISION CENTER
Doing business as
Henderson Vision Center
Practice address
2600 McIngvale Rd
Hernando, MS 38632-8658
Phone
(662) 429-7099
Fax
(662) 469-4091
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Authorized official

Name
Kenya HendersonNPI 1972647519
Title
Owner
Phone
(662) 429-7099

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 741 MS Primary

Addresses

Primary practice location

2600 McIngvale Rd
Hernando, MS 38632-8658

Mailing address

555 Bending Oak S
Hernando, MS 38632-6558
Phone (901) 864-3119

Other identifiers 1

IdentifierTypeStateIssuer
02828236MedicaidMS

Other names 1

  • HENDERSON VISION CENTER Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1306931597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 BENDING OAK S",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386326558",
            "telephone_number": "901-864-3119",
            "fax_number": "662-469-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 MCINGVALE RD",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386328658",
            "telephone_number": "662-429-7099",
            "fax_number": "662-469-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON VISION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "KENYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-429-7099"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02828236",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HENDERSON VISION CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HENDERSON VISION CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hernando, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.