Active NPI
Marissa Lynne Henderson, MSN, APRN, FNP-C
- Nurse Practitioner
- Atlanta, GA
National Provider Identifier
1518502475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP143723
- Practice address
- 1055 Howell Mill Rd NW
Atlanta, GA 30318-5557 - Phone
- (866) 849-0692
- NPI assigned
- Nov 14, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 2025008125 | MO | |
| Nurse Practitioner | 363L00000X | AP143723 | TX | Primary |
| Nurse Practitioner | 363L00000X | AP61670672 | WA | |
| Nurse Practitioner | 363L00000X | 4035650 | KY | |
| Nurse Practitioner | 363L00000X | 38496 | TN | |
| Nurse Practitioner | 363L00000X | APRN11037949 | FL | |
| Nurse Practitioner | 363L00000X | 3-002294 | AL | |
| Nurse Practitioner | 363L00000X | 232324 | AR | |
| Nurse Practitioner | 363L00000X | 907312 | MS | |
| Nurse Practitioner | 363L00000X | C-APN.0103933-C-NP | CO | |
| Nurse Practitioner | 363L00000X | 30139 | SC | |
| Nurse Practitioner | 363L00000X | GAA-NP003247 | GA | |
| Nurse Practitioner | 363L00000X | 322525 | AZ | |
| Nurse Practitioner | 363L00000X | SP032352 | PA | |
| Nurse Practitioner | 363L00000X | 10041652 | OR |
Addresses
Primary practice location
1055 Howell Mill Rd NW
Atlanta, GA 30318-5557
Mailing address
PO Box 211699
Eagan, MN 55121-3699
Phone (866) 849-0692
Other practice location 1
609 Medical Center Dr Ste 2700
Decatur, TX 76234-3839
Phone (940) 627-8020
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | TX | |
| PENDING | Other | TX | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3-002294 | AL | MD | Nurse Practitioner |
| 232324 | AR | MD | Nurse Practitioner |
| 322525 | AZ | MD | Nurse Practitioner |
| C-APN.0103933-C-NP | CO | MD | Nurse Practitioner |
| APRN11037949 | FL | MD | Nurse Practitioner |
| GAA-NP003247 | GA | MD | Nurse Practitioner |
| 4035650 | KY | MD | Nurse Practitioner |
| 2025008125 | MO | MD | Nurse Practitioner |
| 907312 | MS | MD | Nurse Practitioner |
| 10041652 | OR | MD | Nurse Practitioner |
| SP032352 | PA | MD | Nurse Practitioner |
| 38496 | TN | MD | Nurse Practitioner |
| AP61670672 | WA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Devoted Medical Group of Texas Inc | Current | Accepting new patients | |
| Aamir Zuberi MD PA | Current | Accepting new patients | |
| Teresa N. Hill, M.D., P.a. | Past | Accepting new patients | |
| Jon W Walker, M.D. | Past | Accepting new patients | |
| Russell Doubrava DO PA | Past | Accepting new patients | |
| NTSS-Pma PLLC | Past | Accepting new patients |
Locations
609 Medical Center Dr
Ste 2700
Decatur, TX 76234
Phone (940) 627-0013
1201 Fannin St
Ste 262
Houston, TX 77002
Phone (714) 873-6202
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CHBDBA
Organizations & group practices 6
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.
-
- Nephrology Physician
- Decatur, TX
- NPI 1427009075
-
- Primary Care Clinic/Center
- Houston, TX
- NPI 1982202800
-
- Family Medicine Physician
- Decatur, TX
- NPI 1548428766
-
- Interventional Pain Medicine Physician
- Decatur, TX
- NPI 1801146758
-
- Urology Physician
- Decatur, TX
- NPI 1639135452
-
- Obstetrics & Gynecology Physician
- Decatur, TX
- NPI 1578568754
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758499200000",
"number": "1518502475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 211699",
"city": "EAGAN",
"state": "MN",
"postal_code": "551213699",
"telephone_number": "866-849-0692",
"fax_number": "888-973-8821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 HOWELL MILL RD NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303185557",
"telephone_number": "866-849-0692"
}
],
"practiceLocations": [
{
"address_1": "609 Medical Center Dr Ste 2700",
"address_purpose": "LOCATION",
"city": "Decatur",
"state": "TX",
"postal_code": "762343839",
"country_code": "US",
"telephone_number": "940-627-8020",
"fax_number": "940-627-6730",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HENDERSON",
"first_name": "MARISSA",
"middle_name": "LYNNE",
"credential": "MSN, APRN, FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-14",
"last_updated": "2025-09-22",
"certification_date": "2025-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MO",
"license": "2025008125",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "AP143723",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "WA",
"license": "AP61670672",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "4035650",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TN",
"license": "38496",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "APRN11037949",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AL",
"license": "3-002294",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AR",
"license": "232324",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MS",
"license": "907312",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CO",
"license": "C-APN.0103933-C-NP",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "SC",
"license": "30139",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "GAA-NP003247",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AZ",
"license": "322525",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "PA",
"license": "SP032352",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OR",
"license": "10041652",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "PENDING",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; 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.