James M Henderson, M.D.
Individual provider Active NPI Family Medicine Physician · Childress, TX
NPI 1376644286 · NPPES record last updated Dec 23, 2009
Key facts
- NPI
- 1376644286
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- E4398 (TX)
- Practice address
- 1001 Hwy 83 N
Childress, TX 79201 - Phone
- (940) 937-3636
- Fax
- (940) 937-9644
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 19
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Texas Medical School at Houston, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Childress County Hospital District
Practice addresses (Care Compare)
1001 US Hwy 83 N
Childress, TX 79201-2322
Phone (940) 937-3636
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100421000173 | TX | Practitioner - Family Practice |
3173650223 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E4398 | TX | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | E4398 | TX | Yes |
Addresses
Primary practice location
1001 Hwy 83 N
Childress, TX 79201
Mailing address
1001 US Highway 83 N
Childress, TX 79201-2322
Phone (940) 937-3636
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8B4352 | Other | TX | BLUE CROSS BLUE SHIELD |
| 132875910 | Medicaid | TX |
Other providers in Childress, TX
- Mary Sue Green
- Parris Green
- Weldon D Green
- Kimberly Hagar
- Fred E. Hardwicke
- Heritage Vision, PLLC
- Meagan Orene Jarboe Husband
- Peter N Jones
- Cary Shane Keys
- Justin Keys
All providers in Childress, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.