Active NPI
Miquia Sherree Henderson, MD
- Pediatrics Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2018039694
- Practice address
- 615 S New Ballas Rd
Saint Louis, MO 63141-8221 - Phone
- (314) 251-6299
- NPI assigned
- Jun 21, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2018039694 | MO | Primary |
| Pediatrics Physician | 208000000X | 036.152820 | IL |
Addresses
Primary practice location
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Mailing address
4912 Arbors at Stonegate CT
Saint Louis, MO 63123-3057
Other practice location 1
965 Mattox Dr
Sullivan, MO 63080-2365
Phone (573) 860-6000
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, WY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Washington University School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family Care Health Centers
Practice addresses (Care Compare)
401 Holly Hills Ave
Saint Louis, MO 63111-2410
Phone 31448116151306
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.152820 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Hospitals East Communities | Current | Accepting new patients | |
| Mercy Hospitals East Communities | Current | Accepting new patients | |
| St Anthonys Physician Organization Hospitalist Services, L.C. | Current | Accepting new patients | |
| Southern Illinois Healthcare Foundation Inc | Pediatrics | Past | Accepting new patients |
| Bothwell Regional Health Center | Past | Accepting new patients | |
| SSM Health Care St. Louis | Past | Accepting new patients | |
| Southern Illinois Healthcare Foundation Inc | Past | Accepting new patients |
Locations
615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687
10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328
Interoperability endpoints
- mhenderson489547@direct-ehr-ssmhc.com
Organizations & group practices 9
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.
-
dba Mercy Clinic South Hospitalists
- Hospitalist Physician
- Saint Louis, MO
- NPI 1407216336
-
dba Mercy Clinic Southeast
- Family Medicine Physician
- Cape Girardeau, MO
- NPI 1558311522
-
dba County of Sweetwater
- Critical Access Hospital
- Rock Springs, WY
- NPI 1558361949
-
dba Mercy St. Louis Transport Ambulance
- Land Ambulance
- Saint Louis, MO
- NPI 1881329902
-
- General Acute Care Hospital
- Sedalia, MO
- NPI 1235102690
-
dba SSM Health St. Mary's Hospital - St. Louis
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1962572396
-
dba Centreville Health Center
- Federally Qualified Health Center (FQHC)
- Centreville, IL
- NPI 1609813500
Pediatrics
-
dba SIHF Healthcare
- Federally Qualified Health Center (FQHC)
- Waterloo, IL
- NPI 1821813247
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785801600000",
"number": "1457871394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4912 ARBORS AT STONEGATE CT",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631233057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 S NEW BALLAS RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418221",
"telephone_number": "314-251-6299"
}
],
"practiceLocations": [
{
"address_1": "965 Mattox Dr",
"address_purpose": "LOCATION",
"city": "Sullivan",
"state": "MO",
"postal_code": "630802365",
"country_code": "US",
"telephone_number": "573-860-6000",
"fax_number": "573-860-6016",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HENDERSON",
"first_name": "MIQUIA",
"middle_name": "SHERREE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-21",
"last_updated": "2026-08-04",
"certification_date": "2026-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2018039694",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036.152820",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "965 Mattox Dr",
"city": "Sullivan",
"state": "MO",
"country_code": "US",
"postal_code": "630802365",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; 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.