Individual provider Active NPI

Tamika Deanne Henderson

  • Occupational Therapist
  • Waldorf, MD
National Provider Identifier
1699256560
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
3 Post Office Rd Ste 105
Waldorf, MD 20602-2756
Phone
(301) 893-2345
NPI assigned
Aug 28, 2018
Last updated
May 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU Primary

Addresses

Primary practice location

3 Post Office Rd Ste 105
Waldorf, MD 20602-2756

Mailing address

3 Post Office Rd Ste 105
Waldorf, MD 20602-2756

Other identifiers 1

IdentifierTypeStateIssuer
08484OtherMDOCCUPATIONAL THERAPIST, REGISTERED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260312003819 MD Practitioner - Occupational Therapist in Private Practice 7113337080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3084 Waldorf Market PL
Cao Waldorf PT
Waldorf, MD 20603-4872
Phone (240) 530-8188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08484MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates of Central Maryland, PA Past Accepting new patients
Virginia Home Therapy LLC PastSince Nov 22, 2020 Accepting new patients

Organizations & group practices 3

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": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1699256560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 POST OFFICE RD STE 105",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 POST OFFICE RD STE 105",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022756",
            "telephone_number": "301-893-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "TAMIKA",
        "middle_name": "DEANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPIST, REGISTERED",
            "identifier": "08484",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.