Corey Evan Henderson, ARNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

ARNP9310474 Issued in FL

Practice address

4958 Sun N Lake Blvd
Sebring, FL 33872

Phone

(863) 385-8004

Fax

(863) 385-2330

NPI assigned

Oct 21, 2015

Last updated

Jul 9, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thakkar Patel and Avalos MD's LLCGroup PAC ID 5294755617, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Sebring Hospital, Sebring, FL, CCN 100109

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thakkar Patel & Avalos MD's LLC

  • Gastroenterology Physician
  • Sebring, FL
  • NPI 1972565612
  Medicare reassignment Care Compare group NPD
• Compassion First Healthcare, PA

  • General Practice Physician
  • Sebring, FL
  • NPI 1033864913
  NPD
• Sun 'N Lake Medical Group,PA

  • Rural Health Clinic/Center
  • Lake Placid, FL
  • NPI 1144400540
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventist Health System-Sunbelt Inc

  dba AdventHealth Cancer Institute Sebring

  • General Acute Care Hospital
  • Sebring, FL
  • NPI 1083692594
  Care Compare affiliation

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531094400000",
    "number": "1568834224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4958 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722167",
            "telephone_number": "863-385-8004",
            "fax_number": "863-385-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4958 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "33872",
            "telephone_number": "863-385-8004",
            "fax_number": "863-385-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "COREY",
        "middle_name": "EVAN",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-21",
        "last_updated": "2018-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP9310474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015937300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heartland Sleep and Pulmonary Lab LLC
• Moustafa Ahmed Ibrahim Hassan Hegazi, MBBCH
• Lori Carol Helms, LMHC
• Helping Hand Companion Services Inc
• Dalton Kane Helvey, DMD
• Guy Hendricks, BCPS
• Ashleigh Marie Hendry
• Daniel Logan Hendry
• Deborah Mae Hendry, RN
• Havalee Henry, MD

• Primary Care Nurse Practitioner in Sebring, FL
• Providers in Sebring, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2018; 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.

Verify at the official NPI Registry.