Dewanna Henderson, PA-C, BA

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

Practice address

305 S Benedict Ave
Oak Ridge, TN 37830-7310

Phone

(865) 685-0022

NPI assigned

Feb 10, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

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

{
    "created_epoch": "1360454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1699014746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5729 LEBANON RD",
            "address_2": "STE 144-425",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750347260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 S BENEDICT AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378307310",
            "telephone_number": "865-685-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "DEWANNA",
        "credential": "PA-C, BA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-10",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2315",
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7034",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Grant Heald, M.D.
• Amie Nicole Healy
• Raven Michelle Heatherly, NP-C
• Gabrielle Heatwole, LPN
• Keith Heifner, LPC
• Michael A Henderson, MD
• Sarah Elizabeth Hendrix, PA-C, MMS
• Sarah Hepler
• David Dawes Hessert, M.D.
• Amanda N Hill, FNP-BC

• Assistant Behavior Analyst in Oak Ridge, TN
• Providers in Oak Ridge, TN by specialty
• Assistant Behavior Analyst in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.