Henderson Pediatrics, PSC

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

40961 Issued in KY

Legal business name

HENDERSON PEDIATRICS, PSC

Practice address

1035 N Elm St
Henderson, KY 42420-2712

Phone

(270) 827-4596

NPI assigned

Sep 14, 2009

Organization subpart

No

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

Authorized official

Name

Kimberly K Rudd

Title

Billing Specialist

Phone

(270) 827-4596

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252886400000",
    "number": "1497088090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 N ELM ST",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424202712",
            "telephone_number": "270-827-4596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 N ELM ST",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424202712",
            "telephone_number": "270-827-4596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON PEDIATRICS, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-14",
        "last_updated": "2009-09-14",
        "status": "A",
        "authorized_official_last_name": "RUDD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "270-827-4596"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "KY",
            "license": "40961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100005530",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000625514",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Henderson Lab and Xray
• Henderson Manor
• Henderson Opco LLC
• Henderson Orthopaedic Medical Group, PSC
• Henderson Pathology & Cytopathology Services PSC
• Hendersons Minor Outpatient Medicine, LLC
• Kara Dawn Henshaw, FNP-C
• Heather Hensley, OTR
• Amy M Herr, P.T.
• Staci A Hildebrandt, DPT

• Pediatric Adolescent Medicine Physician in Henderson, KY
• Providers in Henderson, KY by specialty
• Pediatric Adolescent Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; 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.