Individual provider Active NPI

Linda Henderson, FNP

  • Family Nurse Practitioner
  • Rusk, TX
National Provider Identifier
1336223643
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
240968 Issued in TX
Practice address
1601 North Dickinson
Rusk, TX 75785-0318
Phone
(903) 683-3421
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 240968 TX Primary

Addresses

Primary practice location

1601 North Dickinson
Rusk, TX 75785-0318

Mailing address

1445 E Main St
Reklaw, TX 75784-2213
Phone (903) 683-3421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050622001288 TX Practitioner - Nurse Practitioner 5991740649 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
240968TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Human Services Commission Current Accepting new patients
Health and Human Services Commission CurrentSince Sep 1, 2017 Accepting new patients

Locations

805 N Dickinson Dr
Rusk, TX 75785
Phone (903) 683-7201

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336223643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 E MAIN ST",
            "city": "REKLAW",
            "state": "TX",
            "postal_code": "757842213",
            "telephone_number": "903-683-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 NORTH DICKINSON",
            "city": "RUSK",
            "state": "TX",
            "postal_code": "757850318",
            "telephone_number": "903-683-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "LINDA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "240968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rusk, TX

Sources for this page

Verify at the official NPI Registry.