Individual provider Active NPI

Ann Craig Henderson, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • New Orleans, LA
National Provider Identifier
1760405609
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
06670R Issued in LA
Practice address
Children'S Hospital - Neurology
200 Henry Clay Avenue
New Orleans, LA 70118
Phone
(504) 896-9859
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 06670R LA Primary

Addresses

Primary practice location

Children'S Hospital - Neurology
200 Henry Clay Avenue
New Orleans, LA 70118

Mailing address

1340 Poydras St
New Orleans, LA 70112-1221
Phone (504) 412-1860

Other identifiers 1

IdentifierTypeStateIssuer
1350915MedicaidLA

Other names 1

  • Ann Henderson Tilton Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071127000148 LA Practitioner - Pediatric Medicine 4486673878 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
06670RLAMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana State University School of Med in New Orleans Faculty Grou CurrentSince Jul 1, 2011 Accepting new patients
Lsu Medical Center Past Accepting new patients
Texas Children'S Physician Group Past Accepting new patients
Lsuhsc New Orleans Physicians Past Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G Past Accepting new patients
Children'S Hospital Past Accepting new patients

Locations

200 Henry Clay Ave
Ste 3312
New Orleans, LA 70118
Phone (504) 896-9319

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1760405609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 POYDRAS ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701121221",
            "telephone_number": "504-412-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHILDREN'S HOSPITAL - NEUROLOGY",
            "address_2": "200 HENRY CLAY AVENUE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70118",
            "telephone_number": "504-896-9859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ANN",
        "middle_name": "CRAIG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "LA",
            "license": "06670R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1350915",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "TILTON",
            "middle_name": "HENDERSON",
            "credential": "MD.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.