NPIMap

Individual provider Active NPI

Joseph Bernard Henderson, D.O.

  • Gastroenterology Physician
  • Fayetteville, NC
National Provider Identifier
1790963759
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2013-00623 Issued in NC
Practice address
2041 Valleygate Dr Ste 101
Fayetteville, NC 28304-3746
Phone
(910) 223-7011
Fax
(910) 323-3650
NPI assigned
Feb 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 2013-00623 NC Primary

Addresses

Primary practice location

2041 Valleygate Dr Ste 101
Fayetteville, NC 28304-3746

Mailing address

PO Box 87112
Fayetteville, NC 28304-7112
Phone (412) 527-8518

Other identifiers 2

IdentifierTypeStateIssuer
2013-00623OtherNCLICENSE #
17953OtherBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130730000303 NC Practitioner - Gastroenterology 6901059401 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Pittsburgh School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cumberland County Hospital System IncGroup PAC ID 1850204041, 581 clinicians
Premier Gastroenterology PAGroup PAC ID 5890787006, 23 clinicians
Cape Fear Valley Health Medical Group LLCGroup PAC ID 0648707109, 352 clinicians

Practice addresses (Care Compare)

1645 Owen Dr
Fayetteville, NC 28304-3425
Phone (910) 615-3668

1880 Quiet CV
Fayetteville, NC 28304-3857
Phone (910) 323-2477

2041 Valleygate Dr
Suite 101
Fayetteville, NC 28304-3746
Phone (910) 223-7011

Hospital & facility affiliations

  • Cape Fear Valley Medical Center Hospital, Fayetteville, NC, CCN 340028
  • Highsmith Rainey Memorial Hospital Long-term care hospital, Fayetteville, NC, CCN 342014

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy51
Upper gastrointestinal (GI) endoscopy for acid reflux600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013-00623NCMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland County Hospital System Inc CurrentSince Sep 6, 2014 Accepting new patients
Cumberland County Hospital System Inc CurrentSince Sep 6, 2014 Accepting new patients
Premier Gastroenterology, PA CurrentSince Apr 1, 2022 Accepting new patients
Cumberland County Hospital System Inc Current Accepting new patients
Fayetteville Gastroenterology Associates, P.a. CurrentSince Aug 1, 2013 Accepting new patients

Locations

1645 Owen Dr
Fayetteville, NC 28304
Phone (910) 486-4486

2041 Valleygate Dr
Fayetteville, NC 28304
Phone (910) 323-5203

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

1880 Quiet Cv
Fayetteville, NC 28304
Phone (910) 323-2477

2041 Valleygate Dr
Ste 101
Fayetteville, NC 28304
Phone (910) 223-7011

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EHJBAA

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1790963759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87112",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283047112",
            "telephone_number": "412-527-8518",
            "fax_number": "910-323-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 VALLEYGATE DR STE 101",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043746",
            "telephone_number": "910-223-7011",
            "fax_number": "910-323-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JOSEPH",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-01",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "2013-00623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "2013-00623",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "17953",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.