Carla Henderson

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

6906892 Issued in FL

Practice address

5103 19TH CT E
Bradenton, FL 34203-4266

Phone

(941) 345-0974

NPI assigned

Jan 17, 2017

Last updated

Jul 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657324800000",
    "number": "1336685106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5103 19TH CT E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342034266",
            "telephone_number": "941-345-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5103 19TH CT E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342034266",
            "telephone_number": "941-345-0974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "CARLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-17",
        "last_updated": "2022-07-09",
        "certification_date": "2022-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906892",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Helpling, PHARMD
• Julie Gaskins Helton, SLP
• Shalini Hemachandran
• Anthony R Hemmer, M.D.
• Tyler Gene Hemphill
• Chad M Henderson, APRN
• Kerrie Ann Henderson, APRN
• Lisa Lynn Henderson, PTA
• Deborah F Hendon, RPH
• William B Hendrix, ARNP

• Adult Care Home Facility in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2022; 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.