Nicholas John Nelson Henderson, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 36249 Issued in CA

Practice address

26302 La Paz Rd
Ste 105
Mission Viejo, CA 92691-5313

Phone

(949) 206-1700

Fax

(949) 206-1800

NPI assigned

Nov 25, 2009

Last updated

May 10, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

California Rehabilitation and Sports Therapy a California Physical theGroup PAC ID 6709788896, 182 clinicians

MDRS Spine and Sport IncGroup PAC ID 3274446687, 181 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• California Rehabilitation & Sports Therapy a California Physical Ther

  dba California Rehabilitation & Sports Therapy

  • Multi-Specialty Clinic/Center
  • Mission Viejo, CA
  • NPI 1386696409

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• MDRS Spine & Sport, Inc

  • Multi-Specialty Clinic/Center
  • San Diego, CA
  • NPI 1952394603
  Medicare reassignment Care Compare group
• California Rehab & Sports Therapy

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1508540279
  NPD
• California Rehabilitation & Sports Therapy a California Physical Ther

  dba California Rehabilitation & Sports Therapy

  • Physical Therapist
  • Irvine, CA
  • NPI 1568414597
  NPD
• California Rehabilitation & Sports Therapy a California Physical Ther

  dba California Rehabilitation & Sports Therapy

  • Physical Therapist
  • Santa Ana, CA
  • NPI 1114978830
  NPD (past)

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

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336608000000",
    "number": "1740518091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEWPORT CENTER DR",
            "address_2": "#213",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607501",
            "telephone_number": "949-644-1322",
            "fax_number": "949-644-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26302 LA PAZ RD",
            "address_2": "STE 105",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926915313",
            "telephone_number": "949-206-1700",
            "fax_number": "949-206-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "NICHOLAS",
        "middle_name": "JOHN NELSON",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-25",
        "last_updated": "2012-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 36249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James A. Heinrich, M.D.
• Helen Stosel MD Inc
• Kevin Helton, RN
• Barry Alan Hench, MD
• Catherine Marie Henderson, REGISTERED DIETITIAN
• Tod Henrichsen, MD
• Mary-Louise H Henson, LMFT
• Absalom D Hepner, M.D.
• Alexandra Lynn Heppert, LMFT
• Herbert Eidt MD, a Medical Corporation

• Physical Therapist in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2012; 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.