NPIMap

Individual provider Active NPI

David Henderson, M.D.

  • Internal Medicine Physician
  • Mena, AR
National Provider Identifier
1306995527
Registry record updated Aug 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E3000 Issued in AR
Practice address
531 Polk 77
Mena, AR 71953-7848
Phone
(479) 437-3602
Fax
(479) 437-3604
NPI assigned
Jan 9, 2007
Last updated
Aug 14, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E3000 AR Primary

Addresses

Primary practice location

531 Polk 77
Mena, AR 71953-7848

Mailing address

531 Polk 77
Mena, AR 71953-7848
Phone (479) 437-3602

Other identifiers 3

IdentifierTypeStateIssuer
E3000OtherARSTATE LICENSE #
145341001MedicaidAR
5L920OtherARBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081030000405 AR Practitioner - Emergency MedicinePractitioner - Internal MedicinePractitioner - Hospitalist 9133292923 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Hospitalist
Education
University of Arkansas College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mena Family Health CenterGroup PAC ID 3971629155, 3 clinicians

Practice addresses (Care Compare)

1103 College Dr
Mena, AR 71953-2519
Phone (479) 394-1414

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E3000ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mena Hospital Commission Current Accepting new patients
Mena Hospital Commission CurrentSince Mar 16, 2012 Accepting new patients
Hailee Elizabeth Rutherford FNP-C PLLC CurrentSince Jul 16, 2025 Accepting new patients
Mena Family Health Center CurrentSince Dec 31, 2021 Accepting new patients
Mena Hospital Commission CurrentSince Mar 16, 2012 Accepting new patients
Felix James Allen, M.D., P.C. Internal Medicine PastSince Apr 16, 2023 Accepting new patients

Locations

1661 Airport Rd
Ste D
Hot Springs National Park, AR 71913
Phone (501) 547-5718

1102 Crestwood Cir
Mena, AR 71953
Phone (479) 234-4433

1103 College Dr
Mena, AR 71953
Phone (479) 394-1414

1706 Highway 71 N
Mena, AR 71953
Phone (479) 394-1500

306 Hornbeck Ave
Mena, AR 71953
Phone (479) 243-6653

311 Morrow St N
Mena, AR 71953
Phone (479) 394-6100

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250208000000",
    "number": "1306995527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 POLK 77",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719537848",
            "telephone_number": "479-437-3602",
            "fax_number": "479-437-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 POLK 77",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719537848",
            "telephone_number": "479-437-3602",
            "fax_number": "479-437-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2009-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E3000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "E3000",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145341001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5L920",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mena, AR

Sources for this page

Verify at the official NPI Registry.