Kenneth Henderson, MSN, APRN, NNP-BC

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

APN.0994788-NP Issued in CO

Practice address

2635 N 7TH St
Grand Junction, CO 81501-8209

Phone

(970) 298-2279

NPI assigned

Jul 17, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

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 and National Provider Directory roles.

• Intermountain Medical Group Grand Junction, LLC

  • Orthopaedic Surgery Physician
  • Grand Junction, CO
  • NPI 1356765556
  Medicare reassignment NPD
• St Mary'S Hospital and Medical Center, Inc

  • Hematology & Oncology Physician
  • Grand Junction, CO
  • NPI 1275714081
  Medicare reassignment NPD
• Intermountain Medical Group Grand Junction, LLC

  • Family Medicine Physician
  • Grand Junction, CO
  • NPI 1538708854
  NPD
• Intermountain Medical Group Grand Junction, LLC

  • Durable Medical Equipment & Medical Supplies
  • Grand Junction, CO
  • NPI 1609737618
  NPD
• St Mary'S Hospital and Medical Center, Inc

  • General Acute Care Hospital
  • Grand Junction, CO
  • NPI 1619742806
  NPD
• St Mary'S Hospital and Medical Center, Inc

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Grand Junction, CO
  • NPI 1699399238
  NPD

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1770136988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 N 7TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018209",
            "telephone_number": "970-298-2279",
            "fax_number": "970-298-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 N 7TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018209",
            "telephone_number": "970-298-2279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2635 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Grand Junction",
            "state": "CO",
            "postal_code": "815018209",
            "country_code": "US",
            "telephone_number": "970-298-2279",
            "fax_number": "970-298-2222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KENNETH",
        "credential": "MSN, APRN, NNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "CO",
            "license": "APN.0994788-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14476351",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Helliwell
• Lydia Hellums, MT
• Carina Helmig
• Helping Hands Electronic Solutions& Supplies
• Chelsea Ann Henderson, LPC
• Trystan Henderson
• Katherine Hendrick, MFTC
• Caroline Howington Hendrix, FNP-C
• Patrick Henke, DO
• Jill Rosati Henneberg, FNP

• Critical Care Neonatal Nurse Practitioner in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Critical Care Neonatal Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.