Larry Henderson

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Practice address

5100 Obannon Dr Apt 78
Las Vegas, NV 89146

Phone

(702) 272-3858

NPI assigned

May 21, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1710399084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 OBANNON DR APT 78",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463426",
            "telephone_number": "702-272-3858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 OBANNON DR APT 78",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89146",
            "telephone_number": "702-272-3858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "LARRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-21",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Henderson
• Katie Henderson
• Katro M Henderson, CADC
• Keri L Henderson
• Kimetha Arlene Henderson
• Leonel Henderson
• Mario Henderson
• Mercedes Henderson
• Monique Danielle Henderson
• Naiomi Henderson

• Early Intervention Provider Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Early Intervention Provider Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; 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.