Gregory L Henderson MD Facs Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

GREGORY L HENDERSON MD FACS INC

Practice address

5800 49TH St. N.
Ste 5108
St. Peterburg, FL 33709-2146

Phone

(727) 390-3937

Fax

(727) 390-3940

NPI assigned

Sep 3, 2021

Organization subpart

Yes

Parent organization

GREGORY L HENDERSON MD FACS INCAs reported in NPPES

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

Authorized official

Name

Mr. Gregory L Henderson Sr., MD

Title

President

Phone

(813) 681-1122

Specialties & licenses 1

Addresses

Tax ID family

Gregory L Henderson MD Facs3 organizations share this tax ID, including this one

Part of

Gregory L Henderson MD Facs

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Gregory L Henderson MD Facs Inc

  • Optometrist
  • Tampa, FL
  • NPI 1932434891
  NPD tax ID
• Gregory L Henderson MD Facs Inc

  • Ophthalmology Physician
  • Tampa, FL
  • NPI 1952139347
  NPD tax ID

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630627200000",
    "number": "1568130441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 VONDERBURG DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115982",
            "telephone_number": "813-681-1122",
            "fax_number": "813-684-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 49TH ST. N.",
            "address_2": "STE 5108",
            "city": "ST. PETERBURG",
            "state": "FL",
            "postal_code": "337092146",
            "telephone_number": "727-390-3937",
            "fax_number": "727-390-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY L HENDERSON MD FACS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREGORY L HENDERSON MD FACS INC",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-681-1122",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allyson Boags
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• Samuel Joseph Holte, LMHC
• Icare St Pete, Inc.
• Charlotte Phillips, ARNP

• Ophthalmology Physician in St. Peterburg, FL
• Providers in St. Peterburg, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.