Kerry Henderson, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0045810 Issued in FL

Practice address

6500 W Newberry Rd
Gainesville, FL 32605-4309

Phone

(352) 333-4900

Fax

(904) 346-0113

NPI assigned

Sep 20, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment NPD
• Nes of Florida Inc

  • Emergency Medicine Physician
  • Gainesville, FL
  • NPI 1063407070
  NPD (past)
• Nes of Florida Inc

  • Emergency Medicine Physician
  • Ocala, FL
  • NPI 1598707689
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407953839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 409036",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303849036",
            "telephone_number": "352-369-0948",
            "fax_number": "904-346-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 W NEWBERRY RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054309",
            "telephone_number": "352-333-4900",
            "fax_number": "904-346-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KERRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0045810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043364100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas Stuart Henderson, DC
• Elizabeth Burford Henderson, PA-C
• Heather Henderson
• Jamira S Henderson
• Joseph Smith Henderson, LMT
• Lalitha Pauliah Henderson, AUD
• Robert R Henderson
• Valerie Lopez Henderson, PHARM.D.
• Viktoria B Henderson
• Deja Hendricks

• Internal Medicine Physician in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.