Active NPI
Maureen Holly Henderson, P.T.
- Physical Therapist
- Edina, MN
National Provider Identifier
1518981422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2353
- Practice address
- 7235 Ohms LN
Edina, MN 55439-2148 - Phone
- (529) 841-2345
- Fax
- (952) 841-2346
- NPI assigned
- Jul 26, 2006
- Last updated
- Aug 12, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2353 | MN | Primary |
Addresses
Primary practice location
7235 Ohms LN
Edina, MN 55439-2148
Mailing address
7235 Ohms LN
Edina, MN 55439-2148
Phone (529) 841-2345
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HP44369 | Other | MN | HEALTHPARTNERS |
| 24373 | Other | MN | AMERICA'S PPO |
| 03A91HE | Other | MN | BCBS OF MN |
| 962871010735 | Other | MN | PREFERRED ONE |
| 6402798 | Other | MN | MEDICA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2353 | MN | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565568000000",
"number": "1518981422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7235 OHMS LN",
"city": "EDINA",
"state": "MN",
"postal_code": "554392148",
"telephone_number": "529-841-2345",
"fax_number": "952-841-2346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7235 OHMS LN",
"city": "EDINA",
"state": "MN",
"postal_code": "554392148",
"telephone_number": "529-841-2345",
"fax_number": "952-841-2346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "MAUREEN",
"middle_name": "HOLLY",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2019-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "2353",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP44369",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICA'S PPO",
"identifier": "24373",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MN",
"identifier": "03A91HE",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "962871010735",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "6402798",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.