Active NPI
Theresa S Henderson, M.D.
- Pediatrics Physician
- Avon, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01045901A
- Practice address
- 8244 E US Highway 36
Suite 210
Avon, IN 46123-9575 - Phone
- (317) 272-7337
- Fax
- (317) 272-8534
- NPI assigned
- Sep 15, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01045901A | IN | Primary |
Addresses
Primary practice location
8244 E US Highway 36
Suite 210
Avon, IN 46123-9575
Mailing address
1100 Southfield Dr
Suite 1370
Plainfield, IN 46168-4498
Phone (317) 837-5571
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200281970A | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | thenderson228580@direct-PRD.stelizabeth.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01045901A | IN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hendricks County Hospital | Pediatrics | Current | Accepting new patients |
| Hendricks County Hospital | Current | Accepting new patients | |
| Hendricks County Hospital | Pediatrics | Current | Accepting new patients |
| Hendricks County Hospital | Past | Accepting new patients | |
| Major Hospital | Past | Accepting new patients | |
| Hendricks County Hospital | Past | Accepting new patients | |
| Hendricks County Hospital | Past | Accepting new patients |
Locations
8244 E US Highway 36
Ste 1340
Avon, IN 46123
Phone (317) 520-5510
8244 E US Highway 36
Ste 210
Avon, IN 46123
Phone (317) 272-7337
8244 E US Highway 36
Ste 1100
Avon, IN 46123
Phone (317) 272-7500
1100 Southfield Dr
Ste 1370
Plainfield, IN 46168
Phone (317) 837-5570
Interoperability endpoints
- https://sehproxy.stelizabeth.com/arr-fhir/api/FHIR/R4
Organizations & group practices 7
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.
-
- General Practice Physician
- Danville, IN
- NPI 1497536163
-
- Pediatrics Physician
- Brownsburg, IN
- NPI 1508758210
-
- Pediatrics Physician
- Avon, IN
- NPI 1972604320
-
- Urgent Care Clinic/Center
- Avon, IN
- NPI 1063411551
-
- Family Medicine Physician
- Plainfield, IN
- NPI 1104927557
-
- Family Medicine Physician
- Avon, IN
- NPI 1598993784
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614902400000",
"number": "1699760645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 SOUTHFIELD DR",
"address_2": "SUITE 1370",
"city": "PLAINFIELD",
"state": "IN",
"postal_code": "461684498",
"telephone_number": "317-837-5571",
"fax_number": "317-837-5580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8244 E US HIGHWAY 36",
"address_2": "SUITE 210",
"city": "AVON",
"state": "IN",
"postal_code": "461239575",
"telephone_number": "317-272-7337",
"fax_number": "317-272-8534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "THERESA",
"middle_name": "S",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-15",
"last_updated": "2021-03-05",
"certification_date": "2021-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01045901A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200281970A",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "thenderson228580@direct-PRD.stelizabeth.com",
"affiliation": "N",
"address_1": "8244 E US Highway 36",
"address_2": "Suite 210",
"city": "Avon",
"state": "IN",
"country_code": "US",
"postal_code": "461239575",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Avon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.