Individual provider Active NPI

Carson Henderson, PA

  • Physician Assistant
  • Lantana, FL
National Provider Identifier
1801648621
Registry record updated Apr 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9118746 Issued in FL
Practice address
928 S Dixie Hwy Unit 470
Lantana, FL 33462-4653
Phone
(561) 794-5068
NPI assigned
Apr 4, 2024
Last updated
Apr 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA66190 CA
Physician Assistant 363A00000X 0110010390 VA
Physician Assistant 363A00000X PA9118746 FL Primary

Addresses

Primary practice location

928 S Dixie Hwy Unit 470
Lantana, FL 33462-4653

Mailing address

928 S Dixie Hwy Unit 470
Lantana, FL 33462-4653

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20240813001647 FL Practitioner - Physician Assistant 5193263895 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inphynet Contracting Services LLCGroup PAC ID 7416865811, 169 clinicians

Practice addresses (Care Compare)

951 N Washington Ave
Titusville, FL 32796-2194
Phone (321) 268-6111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA66190CAMDPhysician Assistant
0110010390VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inphynet Contracting Services LLC Physician Assistant CurrentSince Nov 4, 2025 Accepting new patients
Precision Hormone Replacement Inc Physician Assistant CurrentSince Apr 6, 2025 Accepting new patients
Tenet Florida Physician Services LLC CurrentSince Aug 1, 2024 Accepting new patients
Tenet Florida Physician Services II, LLC CurrentSince Aug 1, 2024 Accepting new patients
Precision Medical BHRT Inc PastSince Apr 28, 2024 Accepting new patients

Locations

3000 Bayview Dr
Ft Lauderdale, FL 33306
Phone (954) 393-1708

928 S Dixie Hwy
Lantana, FL 33462
Phone (561) 794-5068

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743811200000",
    "number": "1801648621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 S DIXIE HWY UNIT 470",
            "city": "LANTANA",
            "state": "FL",
            "postal_code": "334624653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 S DIXIE HWY UNIT 470",
            "city": "LANTANA",
            "state": "FL",
            "postal_code": "334624653",
            "telephone_number": "561-794-5068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "CARSON",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-04",
        "last_updated": "2025-04-05",
        "certification_date": "2025-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA66190",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010390",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lantana, FL

Sources for this page

Verify at the official NPI Registry.