Ericka Patrice Henderson

Primary specialty

Medical Laboratory TechnicianTaxonomy code 246RM2200X

Practice address

1025 Pheasant Dr
Jacksonville, FL 32218-5453

Phone

(904) 789-2141

NPI assigned

May 15, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1487345252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 PHEASANT DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322185453",
            "telephone_number": "904-789-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 PHEASANT DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322185453",
            "telephone_number": "904-789-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ERICKA",
        "middle_name": "PATRICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RM2200X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Medical Laboratory",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Marie Hendershott, M.S., CF-SLP
• Amy Henderson
• Antia R Henderson
• Christopher C Henderson, MD
• Emily Evans Henderson, DNP, APRN, FNP-BC
• Jacob Ray Henderson, DO
• Jacqueline Henderson
• Jessica L Henderson, MSW
• Jimmy Henderson
• Kamiyah Nadine Henderson

• Medical Laboratory Technician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Medical Laboratory Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.