Andrea J Henderson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-3535 Issued in ID

Practice address

5255 W Overland Rd
Boise, ID 83705-2637

Phone

(208) 338-9486

Fax

(208) 338-0171

NPI assigned

Jun 30, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Andrea J Basse Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1356756290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837052637",
            "telephone_number": "208-338-9486",
            "fax_number": "208-338-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837052637",
            "telephone_number": "208-338-9486",
            "fax_number": "208-338-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ANDREA",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-3535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "BASSE",
            "middle_name": "J",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margaret A Henbest, NP
• Michael L Henbest, MD
• Kerry Sean Hendershot, LPC
• Nicole Hendershot, OTR/L
• Henderson Chiropractic PLLC
• Autumn Henderson, M. ED
• Jenna Kaitlyn Henderson, DPT
• Jessica Berry Henderson, PH.D., L.P.C
• Jessica D Henderson, LCSW
• Joan Marie Henderson, EDD

• Physical Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.