Active NPI
Laura Ann Henderson, DPT
- Orthopedic Physical Therapist
- Newport Beach, CA
National Provider Identifier
1801264569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 43076
- Practice address
- 22 Corporate Plaza Dr
Suite 113
Newport Beach, CA 92660-7985 - Phone
- (949) 722-5088
- NPI assigned
- Sep 10, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 43076 | CA | Primary |
Addresses
Primary practice location
22 Corporate Plaza Dr
Suite 113
Newport Beach, CA 92660-7985
Mailing address
10900 Warner Ave
Suite 111
Fountain Valley, CA 92708-3846
Phone (714) 964-3337
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43076 | CA | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441843200000",
"number": "1801264569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10900 WARNER AVE",
"address_2": "SUITE 111",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927083846",
"telephone_number": "714-964-3337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 CORPORATE PLAZA DR",
"address_2": "SUITE 113",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926607985",
"telephone_number": "949-722-5088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "LAURA",
"middle_name": "ANN",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-10",
"last_updated": "2015-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CA",
"license": "43076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.