Stevan Kai Henson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00520 Issued in MS

Practice address

1060 E County Line Rd Ste 6
Ridgeland, MS 39157-1937

Phone

(601) 438-2678

NPI assigned

Aug 12, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Trustcare Primary Care, LLCGroup PAC ID 2961779129, 2 clinicians

Trustcare Health, LLCGroup PAC ID 0547427858, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048
• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stevan.henson.1@19538.direct.athenahealth.com

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.

• Trustcare Health, LLC

  • Family Medicine Physician
  • Ridgeland, MS
  • NPI 1427338235
  Medicare reassignment Care Compare group
• Trustcare Primary Care, LLC

  • Family Medicine Physician
  • Madison, MS
  • NPI 1174078554
  Medicare reassignment Care Compare group
• Northstar Healthcare-Beta LLC

  • Family Medicine Physician
  • Ridgeland, MS
  • NPI 1982299012
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  Care Compare affiliation
• St Dominic-Jackson Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1306876065
  Care Compare affiliation

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1497301915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 E COUNTY LINE RD STE 6",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571937",
            "telephone_number": "601-438-2678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 E COUNTY LINE RD STE 6",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571937",
            "telephone_number": "601-438-2678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "STEVAN",
        "middle_name": "KAI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-12",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cornelius Henderson, DPT
• James Keeton Henderson, LPC
• Branden Henry, PHD.M.A., LPC, LMFTA
• Mark Angelo Henry Sr., LPTA
• John L Henson, DMD
• Valencia Benton Henson, LPTA
• Rebekka S. Herman, SLP
• Peyton L Herrington, PHARMD
• Rachel Melessa Herrington, M OTR/L
• Anna Hicks

• Physician Assistant in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Physician Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.

Verify at the official NPI Registry.