Mark Shea Henderson, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

J4200 Issued in TX

Practice address

135 Plaza Dr
Suite 202
Sikeston, MO 63801-5136

Phone

(573) 472-6003

Fax

(573) 472-7159

NPI assigned

Mar 23, 2006

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 6

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dmcmhende@yourcarecommunity.org
• Direct secure messaging: prmc-mhenderson@primehealthcare.direct-ci.com

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

• Woodlands Health Group, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Spring, TX
  • NPI 1902389521
  Medicare reassignment NPD
• Woodlands Health Group, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Spring, TX
  • NPI 1811537699
  NPD

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1639139876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 PLAZA DR",
            "address_2": "SUITE 202",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015136",
            "telephone_number": "573-472-6003",
            "fax_number": "573-472-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 PLAZA DR",
            "address_2": "SUITE 202",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015136",
            "telephone_number": "573-472-6003",
            "fax_number": "573-472-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MARK",
        "middle_name": "SHEA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "J4200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8BF145",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113358901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113358905",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113358906",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113358907",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE RR",
            "identifier": "990010000",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Jordan Heise, MOT OTR/L
• Beth R Heisler, OTR/L
• Bailey Helbling
• David Ashley Helman, PMHNP-BC
• Leslie Ann Helman, DPT
• Valancia Henderson, FNP
• Karen Elizabeth Henzi, PTA
• Abbey Claire Hester
• Christina Marie Hester
• Kathy Hill, PTA

• Surgery Physician in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.