Active NPI
Barbara Beth Henderson
- Computed Tomography Radiologic Technologist
- Ridgecrest, CA
National Provider Identifier
1629744305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Computed Tomography Radiologic Technologist
- License
- 279593
- Practice address
- 200 N American St
Ridgecrest, CA 93555-3943 - Phone
- (760) 608-0157
- NPI assigned
- Aug 21, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Computed Tomography Radiologic Technologist | 2471C3401X | 279593 | CA | Primary |
Addresses
Primary practice location
200 N American St
Ridgecrest, CA 93555-3943
Mailing address
7125 E Stardust LN
Prescott Valley, AZ 86315-4732
Phone (760) 608-0157
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 279593 | CA | MD | Computed Tomography Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629676800000",
"number": "1629744305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7125 E STARDUST LN",
"city": "PRESCOTT VALLEY",
"state": "AZ",
"postal_code": "863154732",
"telephone_number": "760-608-0157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 N AMERICAN ST",
"city": "RIDGECREST",
"state": "CA",
"postal_code": "935553943",
"telephone_number": "760-608-0157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "BARBARA",
"middle_name": "BETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-21",
"last_updated": "2021-08-23",
"certification_date": "2021-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "2471C3401X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Computed Tomography",
"state": "CA",
"license": "279593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgecrest, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.