Individual provider Active NPI

Patricia Callahan Henderson, CCC-AUDIOLOGIST

  • Audiologist
  • Fall River, MA
National Provider Identifier
1720247893
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
105 Issued in MA
Practice address
300 Hanover St
Fall River, MA 02720-5444
Phone
(508) 679-7709
NPI assigned
Jun 4, 2008
Last updated
Jun 4, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 105 MA Primary

Addresses

Primary practice location

300 Hanover St
Fall River, MA 02720-5444

Mailing address

22 Timothy Dr
West Bridgewater, MA 02379-1144
Phone (508) 584-5347

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090406000536 MA Practitioner - Qualified Audiologist 9537216700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

299 Faunce Corner Rd
North Dartmouth, MA 02747-6244
Phone (508) 995-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105MAMDDoula

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. Current Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Apr 1, 2021 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Apr 1, 2021 Accepting new patients
Thomas F Cahill MD LTD Past Accepting new patients

Locations

300 Hanover St
Fall River, MA 02720
Phone (508) 677-0700

300 Hanover St
Ste 4A
Fall River, MA 02720
Phone (508) 677-0700

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

299 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 995-0700

Organizations & group practices 4

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": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212537600000",
    "number": "1720247893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 TIMOTHY DR",
            "city": "WEST BRIDGEWATER",
            "state": "MA",
            "postal_code": "023791144",
            "telephone_number": "508-584-5347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HANOVER ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205444",
            "telephone_number": "508-679-7709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "PATRICIA",
        "middle_name": "CALLAHAN",
        "credential": "CCC-AUDIOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-04",
        "last_updated": "2008-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; 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.