NPIMap

Individual provider Active NPI

James Alan Henderson, MD

  • Adolescent Medicine (Family Medicine) Physician
  • Columbia, SC
National Provider Identifier
1689840514
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X
License
30952 Issued in SC
Practice address
115 Blarney Dr Ste 212
Columbia, SC 29223-6291
Phone
(803) 254-5171
Fax
(803) 779-7403
NPI assigned
Apr 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) Physician 207QA0000X 30952 SC Primary

Addresses

Primary practice location

115 Blarney Dr Ste 212
Columbia, SC 29223-6291

Mailing address

115 Blarney Dr Ste 212
Columbia, SC 29223-6291
Phone (803) 254-5171

Other identifiers 1

IdentifierTypeStateIssuer
309525MedicaidSC

Other names 1

  • J Alan Hernderson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120907000133 SC Practitioner - Family Practice 3375791809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Family Practice LLCGroup PAC ID 4284658865, 4 clinicians

Practice addresses (Care Compare)

115 Blarney Dr
Columbia, SC 29223-6291
Phone (803) 254-5171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.89 of 100Reported as group
Quality
90.18
Improvement activities
40
Cost
79.37

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy13
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue25
Removal of skin lesions13
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Family Practice LLC CurrentSince Aug 1, 2012 Accepting new patients

Locations

2750 Laurel St
Ste 103
Columbia, SC 29204
Phone (803) 254-5171

Interoperability endpoints

  • Direct secure messaging: jameshenderson@providencefp.amazing-direct.com
  • Direct secure messaging: jhenderson380431@direct.musc.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1689840514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 BLARNEY DR STE 212",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236291",
            "telephone_number": "803-254-5171",
            "fax_number": "803-779-7403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BLARNEY DR STE 212",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236291",
            "telephone_number": "803-254-5171",
            "fax_number": "803-779-7403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JAMES",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "SC",
            "license": "30952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "309525",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J",
            "last_name": "HERNDERSON",
            "middle_name": "ALAN",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.