Individual provider Active NPI

Tatonisha Lasha Green-Henderson, FNP-BC

  • Family Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1396404117
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1067977 Issued in TX
Practice address
5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone
(214) 590-8000
Fax
(214) 645-6257
NPI assigned
Dec 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 657879 TX
Pediatric Nurse Practitioner 363LP0200X 1067977 TX
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 1067977 TX Primary

Addresses

Primary practice location

5200 Harry Hines Blvd
Dallas, TX 75235-7709

Mailing address

PO Box 845347
Dallas, TX 75284-5347

Other names 1

  • Tatonisha Lasha Green-Henderson Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220228000978 TX Practitioner - Nurse Practitioner 1355735879 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2001 Inwood Rd
Dallas, TX 75390-7202
Phone (214) 645-0538

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1067977TXMDFamily Nurse Practitioner
657879TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Federico Maese MD PA Single Specialty CurrentSince Mar 1, 2022 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 1, 2023 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 1, 2023 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Single Specialty Current Accepting new patients

Locations

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

5151 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-3000

408 S Cesar Chavez Blvd
Dallas, TX 75201
Phone (214) 760-9701

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

1935 Medical District Dr
Unit A
Dallas, TX 75235

420 W 2nd St
Irving, TX 75060
Phone (214) 760-9701

269 E Ovilla Rd
Ste 100
Red Oak, TX 75154
Phone (469) 719-3690

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

2001 Inwood Rd
Ut Southwest Medical Center, TX 75390
Phone (214) 645-8000

Organizations & group practices 4

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 1

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": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1396404117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357709",
            "telephone_number": "214-590-8000",
            "fax_number": "214-645-6257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN-HENDERSON",
        "first_name": "TATONISHA",
        "middle_name": "LASHA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "657879",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1067977",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1067977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TATONISHA",
            "last_name": "GREEN-HENDERSON",
            "middle_name": "LASHA",
            "credential": "FNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.