Michael James Henderson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP60851799 Issued in WA

Practice address

380 Chase Ave
Walla Walla, WA 99362-2924

Phone

(509) 897-3000

NPI assigned

Jun 20, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

King County Public Hospital District No 2Group PAC ID 7618880097, 586 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• King County Public Hospital District No 2

  • Neuromusculoskeletal Medicine & OMM Physician
  • Kirkland, WA
  • NPI 1801986070
  Medicare reassignment Care Compare group NPD
• King County Public Hospital District No 2

  • Family Medicine Physician
  • Bothell, WA
  • NPI 1902907165
  NPD
• King County Public Hospital District No. 2

  • Physical Therapist
  • Kirkland, WA
  • NPI 1356920946
  NPD
• King County Public Hospital District No. 2

  • Clinic/Center
  • Redmond, WA
  • NPI 1750612883
  NPD
• Eureka Volunteer Ambulance Service Inc

  • Land Ambulance
  • Eureka, MT
  • NPI 1215995907
  NPD
• Logan Health - Whitefish

  • Rural Health Clinic/Center
  • Eureka, MT
  • NPI 1336115849
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• King County Public Hospital District No. 2

  • General Acute Care Hospital
  • Kirkland, WA
  • NPI 1033174933
  Care Compare affiliation

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1407340730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 CHASE AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622924",
            "telephone_number": "509-897-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 CHASE AVE",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622924",
            "telephone_number": "509-897-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1675 Talbot Road",
            "address_purpose": "LOCATION",
            "city": "Columbia Falls",
            "state": "MT",
            "postal_code": "59912",
            "country_code": "US",
            "telephone_number": "406-892-3208",
            "fax_number": "406-892-4497",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 S 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Walla Walla",
            "state": "WA",
            "postal_code": "993624116",
            "country_code": "US",
            "telephone_number": "509-897-3000",
            "fax_number": "509-897-5899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60851799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhenderson951255@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1025 S 2nd Ave",
            "city": "Walla Walla",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993624116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sandra J Heilman, MA
• Sheryl Joan Heinrich, RN
• Ingrid Emily Heintzberger, EAMP
• Sara E Hellberg, ARNP
• Karen Henderson, MD
• Richard Lyle Henderson, M.D.
• Spencer Scott Hendricks, PMHNP
• Herbert C Edwards, DDS, PLLC
• Joseph F Herbert
• Anna Herby, RDN

• Family Nurse Practitioner in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.

Verify at the official NPI Registry.