Individual provider Active NPI

Stephen Brown Henderson, MD

  • Family Medicine Physician
  • Guntersville, AL
National Provider Identifier
1366523110
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9278 Issued in AL
Practice address
2308 Homer Clayton Dr
Guntersville, AL 35976-2206
Phone
(256) 582-2581
Fax
(256) 582-7799
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9278 AL Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 9278 AL
Sports Medicine (Family Medicine) Physician 207QS0010X 9278 AL

Addresses

Primary practice location

2308 Homer Clayton Dr
Guntersville, AL 35976-2206

Mailing address

2308 Homer Clayton Dr
Guntersville, AL 35976-2206
Phone (256) 582-2581

Other identifiers 2

IdentifierTypeStateIssuer
144869MedicaidAL
144705MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050930000113 AL Practitioner - Family PracticePractitioner - Geriatric Medicine 3173558905 Receives reassigned benefits from 1 practitioner
Practice locations: Guntersville, AL; New Hope, AL

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
University of South Alabama College of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2308 Homer Clayton Dr
Guntersville, AL 35976-2206
Phone (256) 582-2581

Hospital & facility affiliations

  • Medical Centers Homecare Home health agency, Albertville, AL, CCN 017128
  • Marshall Medical Centers Hospital, Boaz, AL, CCN 010005
  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039
  • Marshall Manor Nursing Home Nursing home, Guntersville, AL, CCN 015378

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9278ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson and Darnell Associates Family Medicine Past Accepting new patients
Stephen B Henderson Family Medicine PastSince Jan 1, 2013 Accepting new patients
Stephen B Henderson Family Medicine PastSince Jan 1, 2013 Accepting new patients

Networks

  • bcbs alabama network 01B0
  • bcbs alabama network 01G0
  • bcbs alabama network 01C0
  • bcbs alabama network 01H0
  • bcbs alabama network 01E0

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 3

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 4

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1366523110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 HOMER CLAYTON DR",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359762206",
            "telephone_number": "256-582-2581",
            "fax_number": "256-582-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 HOMER CLAYTON DR",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359762206",
            "telephone_number": "256-582-2581",
            "fax_number": "256-582-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "STEPHEN",
        "middle_name": "BROWN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "9278",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AL",
            "license": "9278",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "AL",
            "license": "9278",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144869",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144705",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Guntersville, AL

Sources for this page

Verify at the official NPI Registry.