Nathan Henderson, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

1013 Issued in SC

Practice address

14 Richland Medical Park Dr
Suite 320
Columbia, SC 29203

Phone

(803) 434-6771

Fax

(803) 434-3955

NPI assigned

Jul 25, 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

Enrolled in SC

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 Osteopathy, Doctor of Medicine

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 and National Provider Directory roles.

• Prisma Health Medical Group-Midlands

  • Multi-Specialty Clinic/Center
  • Columbia, SC
  • NPI 1275988321

  Internal Medicine

  NPD
• Prisma Health Medical Group-Midlands

  • Durable Medical Equipment & Medical Supplies
  • Columbia, SC
  • NPI 1881469856
  NPD

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1669495347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK DR",
            "address_2": "SUITE 320",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-6771",
            "fax_number": "803-434-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "1013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010133",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00924676",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denijah Henderson
• Eboneika D. Henderson, LPC
• Frampton W Henderson Jr., MD
• James Alan Henderson, MD
• Kitty Caughman Henderson, LPC
• Rickey E Henderson, MA
• Samuel Henderson, M.D.
• Silas Henderson, RBT
• Susan Marie Henderson, PA-C
• Tara Christine Henderson

• Internal Medicine Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.