NPIMap

Organization Active NPI

Patricia W Henderson DO PC

  • Family Medicine Physician
  • Low Moor, VA
National Provider Identifier
1508059429
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102037111 Issued in VA
Legal business name
PATRICIA W HENDERSON DO PC
Practice address
1 Arh Lane
Suite 800
Low Moor, VA 24457
Phone
(540) 862-6750
Fax
(540) 862-3742
NPI assigned
Aug 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Authorized official

Name
Dr. Patricia W Henderson, D.O.
Title
Owner
Phone
(540) 862-6750

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 0102037111 VA Primary
Medical Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363AM0700X 0110001381 VA

Addresses

Primary practice location

1 Arh Lane
Suite 800
Low Moor, VA 24457

Mailing address

PO Box 629
Clifton Forge, VA 24422-0629
Phone (540) 862-6750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080710000207 VA Part B Supplier - Clinic/Group Practice 9537231345 Receives reassigned benefits from 3 practitioners
Practice locations: Low Moor, VA

National Provider Directory

National Provider Directory

Locations

200 Arh Ln
#800
Covington, VA 24426
Phone (540) 862-6750

1 Arh Ln
#800
Low Moor, VA 24457
Phone (540) 862-6659

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13858/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464825600000",
    "number": "1508059429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 629",
            "city": "CLIFTON FORGE",
            "state": "VA",
            "postal_code": "244220629",
            "telephone_number": "540-862-6750",
            "fax_number": "540-862-3742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ARH LANE",
            "address_2": "SUITE 800",
            "city": "LOW MOOR",
            "state": "VA",
            "postal_code": "24457",
            "telephone_number": "540-862-6750",
            "fax_number": "540-862-3742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIA W HENDERSON DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2016-06-02",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-862-6750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102037111",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110001381",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Low Moor, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.