NPIMap

Individual provider Active NPI

John M. Henderson Sr., D.O.

  • Family Medicine Physician
  • Columbus, GA
National Provider Identifier
1477597979
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
025765 Issued in GA
Practice address
1900 10TH Ave Suite 320
Columbus, GA 31901
Phone
(706) 323-5717
Fax
(855) 681-1414
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 025765 GA Primary

Addresses

Primary practice location

1900 10TH Ave Suite 320
Columbus, GA 31901

Mailing address

1900 10TH Ave Ste 320
Columbus, GA 31901-3610
Phone (706) 323-5717

Other identifiers 1

IdentifierTypeStateIssuer
025765OtherGASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031226000001 GA Practitioner - Family PracticePractitioner - Orthopedic Surgery 3173421351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
John M Henderson DO PCGroup PAC ID 3476537465, 2 clinicians

Practice addresses (Care Compare)

1900 10TH Ave
Suite 320
Columbus, GA 31901-3610
Phone (706) 323-5717

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Columbus, GA, CCN 117306
  • Centerwell Home Health Home health agency, Columbus, GA, CCN 117056
  • Prohealth Home Health-Georgia, LLC Home health agency, Columbus, GA, CCN 117140
  • Amedisys Home Health of Macon Home health agency, Macon, GA, CCN 117093
  • Gentiva Hospice, Columbus, GA, CCN 111560
  • St Francis Hospital- Emory Healthcare Hospital, Columbus, GA, CCN 110129
  • Piedmont Columbus Regional Midtown Hospital, Columbus, GA, CCN 110064
  • Piedmont Columbus Regional Northside Hospital, Columbus, GA, CCN 110200
  • Columbus Specialty Hospital, Inc Long-term care hospital, Columbus, GA, CCN 112012
  • River Towne Center Nursing home, Columbus, GA, CCN 115566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
025765GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John M Henderson DO PC Single Specialty CurrentSince Apr 1, 2004 Accepting new patients
Columbus Center LLC Single Specialty Past Accepting new patients
Affabilis LLC Past Accepting new patients

Locations

1900 10th Ave
Ste 320
Columbus, GA 31901
Phone (706) 323-5717

2300 Manchester Expy
Ste G2
Columbus, GA 31904
Phone (706) 323-5717

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBBGDD
  • FHIR API: https://fhir-usa.unify.chbase.com/org/colspec-56652950

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
River Towne CenterColumbus, GA, CCN 115566 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 31, 2018
Oct 31, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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 10

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1477597979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 10TH AVE STE 320",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319013610",
            "telephone_number": "706-323-5717",
            "fax_number": "877-569-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 10TH AVE SUITE 320",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31901",
            "telephone_number": "706-323-5717",
            "fax_number": "855-681-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JOHN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "025765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "025765",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.