Reggie Allan Henderson, M.D.
Individual provider Active NPI Family Medicine Physician · Lexington, TN
NPI 1528058765 · NPPES record last updated Jun 14, 2024
Key facts
- NPI
- 1528058765
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 12019 (TN)
- Practice address
- 200 W Church St
Lexington, TN 38351-2038 - Phone
- (731) 968-3646
- Fax
- (731) 968-1870
- NPI assigned
- Oct 27, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 19
Hospital & facility affiliations 5
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Arkansas College of Medicine, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lexington Hospital Corporation
Lexington Clinic Corp
Practice addresses (Care Compare)
200 W Church St
Lexington, TN 38351-2038
Phone (731) 968-1812
5001 E Main St
Erin, TN 37061-4115
Phone (336) 944-6420
Hospital & facility affiliations
- Haywood County Community Hospital
- Houston County Community Hospital
- Henderson County Community Hospital
- Jackson-Madison County General Hospital
- Briarwood Community Living Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 22.68 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 75.61
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Briarwood Community Living Center |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Sep 1, 2016 Sep 1, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050113000455 | TN | Practitioner - Family Practice | 8123091113 | Reassigns benefits to 8 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12019 | TN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shamrock Community Hospital Inc. | Current |
Accepting new patients | |
| Haywood County Community Hospital Inc | Current |
Accepting new patients | |
| Haywood County Community Hospital, Inc | Emergency Medicine | Current |
Accepting new patients |
| Lexington Hospital Corporation | Emergency Medicine | Current | Accepting new patients |
| Lexington Hospital Corporation | Emergency Medicine | Current |
Accepting new patients |
| Shamrock Community Hospital Inc | Emergency Medicine | Current |
Accepting new patients |
| Shamrock Community Hospital Inc | Current | Accepting new patients | |
| Lexington Clinic Corp | Emergency Medicine | Current |
Accepting new patients |
| CLC of Lexington, LLC | Past | Accepting new patients | |
| Lexington Hospital Corporation | Past |
Accepting new patients | |
| Haywood County Community Hospital Inc | Past | Accepting new patients | |
| Unity Hospice Care of Tennessee, LLC | Family Medicine | Past | Accepting new patients |
| Beechlake Emergency Physicians | Emergency Medicine | Past | Accepting new patients |
Locations
2545 N Washington Ave
Ste B
Brownsville, TN 38012
Phone (931) 289-4211
2545 N Washington Ave
Brownsville, TN 38012
Phone (731) 307-3777
2545 N Washington Ave
Ste 2
Brownsville, TN 38012
5001 E Main St
Erin, TN 37061
Phone (336) 944-6420
270 W Church St
Ste B
Lexington, TN 38351
Phone (731) 271-5994
250 Boswell St
Lexington, TN 38351
Phone (731) 968-2006
200 W Church St
Lexington, TN 38351
Phone (731) 968-1812
270 W Church St
Ste A
Lexington, TN 38351
Phone (731) 968-0133
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/henders-823c208a
- henderra@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 12019 | TN | |
| Internal Medicine Physician | 207R00000X | 12019 | TN | |
| Pediatrics Physician | 208000000X | 12019 | TN | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 12019 | TN | |
| Diagnostic Radiology Physician | 2085R0202X | 12019 | TN | |
| Surgery Physician | 208600000X | 12019 | TN | |
| Family Medicine Physician | 207Q00000X | 12019 | TN | Yes |
Addresses
Primary practice location
200 W Church St
Lexington, TN 38351-2038
Mailing address
200 W Church St
Lexington, TN 38351-2038
Phone (731) 968-3646
Other practice location 1
5001 E Main St
Erin, TN 37061-4115
Phone (931) 289-4211
Other practice location 2
270 W Church St Ste A
Lexington, TN 38351-2077
Phone (731) 968-3646
Other practice location 3
2545 N Washington Ave
Brownsville, TN 38012-1610
Phone (931) 289-4211
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4057341 | Other | TN | BLUE CROSS BLUE SHIELD |
| 626001636 | Other | TN | USA MANAGED CARE |
| 152666 | Other | TN | UNISON |
| JT1012 | Other | TN | CIGNA |
| P00034973 | Other | TN | RAILROAD MEDICARE |
| 3189726 | Medicaid | TN | |
| 626001636 | Other | TN | HEALTH PARTNERS |
| 27415 | Other | TN | TLC |
| 626001636 | Other | TN | UNITED HEALTHCARE |
Other providers in Lexington, TN
- Holli Helms
- Henderson Co Health Dept
- Henderson Co Health Dept
- Henderson Co Health Dept
- Henderson County Clinic of Chiropractic PLLC
- Tara Hendrix
- Heritage Place of Lexington, Inc.
- Deidra Diane Holland
- Home Medical Products, Inc
- Hometown Health and Wellness PLLC
All providers in Lexington, TN · Family Medicine Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.