Individual provider Active NPI

Laura Ann Henderson, DPT

  • Orthopedic Physical Therapist
  • Newport Beach, CA
National Provider Identifier
1801264569
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
43076 Issued in CA
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

Updated by the provider on Sep 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
43076CAMDOrthopedic 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.

Verify at the official NPI Registry.