Mario Henderson

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

5450 E. Lake Mead Blvd
Building D Apt. 225
Las Vegas, NV 89156-0908

Phone

(702) 689-6742

NPI assigned

Jul 25, 2019

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

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": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1760036032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 E. LAKE MEAD BLVD.",
            "address_2": "BUILDING D APT. 225",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89156",
            "telephone_number": "702-689-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 E. LAKE MEAD BLVD",
            "address_2": "BUILDING D APT. 225",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891560908",
            "telephone_number": "702-689-6742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MARIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-25",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katro M Henderson, CADC
• Keri L Henderson
• Kimetha Arlene Henderson
• Larry Henderson
• Leonel Henderson
• Mercedes Henderson
• Monique Danielle Henderson
• Naiomi Henderson
• Najhala Sparkle Henderson
• Nichole Henderson

• Personal Care Attendant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Personal Care Attendant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.