Individual provider Active NPI

Gesele Henderson

  • Emergency Medicine Physician
  • Warwick, RI
National Provider Identifier
1780470740
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
LP06571 Issued in RI
Practice address
455 Toll Gate Rd
Warwick, RI 02886-2759
Phone
(401) 737-7010
NPI assigned
Apr 16, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X LP06571 RI Primary

Addresses

Primary practice location

455 Toll Gate Rd
Warwick, RI 02886-2759

Mailing address

455 Toll Gate Rd
Warwick, RI 02886-2759

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250723002395 RI Order and Referring Only - PodiatryPractitioner - Podiatry 2365958501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP06571RIMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1780470740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-737-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "GESELE",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "LP06571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.