Christy M. Henderson-Peterson, N.P.

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

NP11839 Issued in CA

Practice address

1721 Hammer Lane Suite a
Stockton, CA 95210-4116

Phone

(209) 751-5200

NPI assigned

Oct 18, 2006

Last updated

Feb 1, 2013By the provider in NPPES

Sex

Female

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 CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chendersonpeterson761581@direct.ochin.org
• Direct secure messaging: christy.hendersonpeterson.p1@direct.cmcentersinc.nextgenshare.com

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.

• Community Medical Centers, Inc.

  dba Esparto Family Practice

  • Federally Qualified Health Center (FQHC)
  • Esparto, CA
  • NPI 1588729180
  Medicare reassignment NPD
• Community Medical Centers Inc

  dba Community Medical Centers, Lodi East

  • Federally Qualified Health Center (FQHC)
  • Lodi, CA
  • NPI 1891529061
  NPD
• Community Medical Centers, Inc.

  dba Lawrence Family Center & Clinic

  • Federally Qualified Health Center (FQHC)
  • Lodi, CA
  • NPI 1659435279
  NPD
• Community Medical Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Stockton, CA
  • NPI 1538223375
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1609957190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95201",
            "telephone_number": "209-373-2829",
            "fax_number": "209-373-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 HAMMER LANE SUITE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952104116",
            "telephone_number": "209-751-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON-PETERSON",
        "first_name": "CHRISTY",
        "middle_name": "M.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CA",
            "license": "NP11839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "NP11839",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Helios Healthcare, LLC (Elmhaven Care Center)
• Jenna Hellige, PPS
• Sherri Helsby, LCSW
• Jeffrey Tevin Hen, CRNA
• Mikayla Henard
• Debra Quennette Henderson
• Kathleen Henderson
• Keiland Maurice Henderson
• Lawrence Henderson
• Makayla Henderson

• Licensed Practical Nurse in Stockton, CA
• Providers in Stockton, CA by specialty
• Licensed Practical Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.