Randal Hollis Henderson, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

ME36677 Issued in FL

Practice address

2015 N. Jefferson St.
Jacksonville, FL 32206

Phone

(904) 588-1800

NPI assigned

Mar 31, 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: rhenderson@directaddress.net

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1649231291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 116304",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303686304",
            "telephone_number": "904-588-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 N. JEFFERSON ST.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32206",
            "telephone_number": "904-588-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "RANDAL",
        "middle_name": "HOLLIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME36677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2552299-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000432264G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kamiyah Nadine Henderson
• Luke Butler Henderson, D.O.
• Meesha Prakash Henderson, LMHC
• Megan Henderson, PHARMD
• Natasha Nicole Henderson, ARNP
• Skylar Henderson
• Sydney Henderson
• Kathryn M Hendley, MS-CCC-SLP
• Nathaniel Hendley
• Keiarra Hendrick

• Radiation Oncology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Radiation Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.