Active NPI
Teresa Joyce Henderson, NP
- Family Nurse Practitioner
- Abingdon, VA
National Provider Identifier
1346013182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 0024188659
- Practice address
- 27078 Rich Valley Rd
Abingdon, VA 24210-8938 - Phone
- (276) 608-6558
- NPI assigned
- Nov 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024188659 | VA | Primary |
Addresses
Primary practice location
27078 Rich Valley Rd
Abingdon, VA 24210-8938
Mailing address
27078 Rich Valley Rd
Abingdon, VA 24210-8938
Phone (276) 608-6558
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240311001102 | TN | Practitioner - Nurse Practitioner | 9830535020 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- East Tennessee State University Quillen College of Medicine, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southeastern Physician Services PC
Practice addresses (Care Compare)
400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111
Hospital & facility affiliations
- Johnson City Medical Center
- Greeneville Community Hospital
- Franklin Woods Community Hospital
- Sycamore Shoals Hospital
- Wellmont Bristol Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024188659 | VA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Physician Services PC | Current | Accepting new patients |
Locations
1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325
400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310
1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061
Organizations & group practices 1
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.
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Johnson City, TN
- NPI 1114033628
Hospital
-
- General Acute Care Hospital
- Elizabethton, TN
- NPI 1891801734
Hospital
-
- General Acute Care Hospital
- Johnson City, TN
- NPI 1972606465
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698883200000",
"number": "1346013182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27078 RICH VALLEY RD",
"city": "ABINGDON",
"state": "VA",
"postal_code": "242108938",
"telephone_number": "276-608-6558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27078 RICH VALLEY RD",
"city": "ABINGDON",
"state": "VA",
"postal_code": "242108938",
"telephone_number": "276-608-6558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "TERESA",
"middle_name": "JOYCE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-02",
"last_updated": "2023-11-02",
"certification_date": "2023-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "VA",
"license": "0024188659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Abingdon, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.