Individual provider Active NPI

William W Henderson IV, M.D.

  • Pulmonary Disease Physician
  • Danville, VA
National Provider Identifier
1497755680
Registry record updated Jan 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
0101035148 Issued in VA
Practice address
159 Executive Dr
Suite F
Danville, VA 24541-4160
Phone
(434) 792-4378
NPI assigned
Jul 28, 2005
Last updated
Jan 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 0101035148 VA Primary

Addresses

Primary practice location

159 Executive Dr
Suite F
Danville, VA 24541-4160

Mailing address

159 Executive Dr
Suite F
Danville, VA 24541-4160
Phone (434) 792-4378

Other identifiers 1

IdentifierTypeStateIssuer
006041710MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091207000504 VA Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 7416927652 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01158NCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Danville Physician Practices LLC CurrentSince Jun 1, 2015 Accepting new patients
Danville Physician Practices LLC CurrentSince Jun 1, 2015 Accepting new patients
Apogee Medical Group Virginia, PC CurrentSince Apr 1, 2012 Accepting new patients
Greensboro Pathology, LLC Current Accepting new patients

Locations

142 S Main St
Danville, VA 24541
Phone (434) 799-2100

159 Executive Dr
Ste F
Danville, VA 24541
Phone (434) 792-4378

320 Hospital Dr
Martinsville, VA 24112
Phone (276) 666-7200

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19847/brand/3/csg/21/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389830400000",
    "number": "1497755680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 EXECUTIVE DR",
            "address_2": "SUITE F",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245414160",
            "telephone_number": "434-792-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 EXECUTIVE DR",
            "address_2": "SUITE F",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245414160",
            "telephone_number": "434-792-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "WILLIAM",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2014-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "VA",
            "license": "0101035148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006041710",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.