Individual provider Active NPI

Lauren J Henderson, MNT

  • Registered Dietitian
  • Rock Hill, SC
National Provider Identifier
1689740771
Registry record updated Apr 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
13597 Issued in SC
Practice address
1721 Ebenezer Rd
Suite 145
Rock Hill, SC 29732-4103
Phone
(803) 328-2401
Fax
(803) 328-1030
NPI assigned
Nov 28, 2006
Last updated
Apr 8, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 13597 SC Primary

Addresses

Primary practice location

1721 Ebenezer Rd
Suite 145
Rock Hill, SC 29732-4103

Mailing address

PO Box 2617
Rock Hill, SC 29732-4617
Phone (803) 328-2401

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
13597SCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Hill GYN & OB Associates, PA Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270684800000",
    "number": "1689740771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2617",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297324617",
            "telephone_number": "803-328-2401",
            "fax_number": "803-328-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 EBENEZER RD",
            "address_2": "SUITE 145",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297324103",
            "telephone_number": "803-328-2401",
            "fax_number": "803-328-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "LAUREN",
        "middle_name": "J",
        "credential": "MNT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2010-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "SC",
            "license": "13597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.