Todd Russell Henderson, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Kechi, KS
NPI 1801864657 · NPPES record last updated Oct 31, 2008
Key facts
- NPI
- 1801864657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 55469 (KS)
- Practice address
- 452 Cheyenne CT
Kechi, KS 67067-8630 - Phone
- (316) 841-7042
- NPI assigned
- Mar 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 9
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- University of Kansas School of Med (KC/Wich/Sal), 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Anesthesia Medical Professionals PLLC
Orthomed Staffing LLC
Practice addresses (Care Compare)
4801 Integris Pkwy
Edmond, OK 73034-8864
Phone (405) 713-4565
8100 S Walker Ave
BLDG C
Oklahoma City, OK 73139-9404
Phone (405) 602-6500
Hospital & facility affiliations
- Oklahoma Center for Orthopaedic & Multi-SP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050801000633 | OK | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 9739122870 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55469 | KS | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hpi Physicians LLC | Current |
Accepting new patients | |
| Mercy Hospital Kingfisher, Inc | Current |
Accepting new patients | |
| Orthomed Staffing LLC | Current |
Accepting new patients | |
| Anesthesia Medical Professionals, PLLC | Current |
Accepting new patients | |
| North Texas Anesthesia Group L.L.P. | Past | Accepting new patients | |
| Jackson County Memorial Hospital Authority | Past | Accepting new patients | |
| Newton Anesthesia Services PA | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| North Texas Anesthesia Group L.L.P | Past | Accepting new patients |
Locations
1705 Renaissance Blvd
Ste 120
Edmond, OK 73013
Phone (405) 715-4496
4801 Integris Pkwy
Edmond, OK 73034
Phone (405) 657-3000
1000 Hospital Dr
Kingfisher, OK 73750
Phone (405) 375-3141
8100 S Walker Ave
Bldg C
Oklahoma City, OK 73139
Phone (405) 602-6500
4401 S Western Ave
Oklahoma City, OK 73109
Phone (405) 636-7000
14024 Quail Pointe Dr
Oklahoma City, OK 73134
Phone (405) 419-8447
5925 NW 139th St
Oklahoma City, OK 73142
Phone (405) 621-8800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 55469 | KS | Yes |
Addresses
Primary practice location
452 Cheyenne CT
Kechi, KS 67067-8630
Mailing address
452 Cheyenne CT
Kechi, KS 67067-8630
Phone (316) 841-7042
Other providers in Kechi, KS
- Jason Felihkatubbe
- Brooke McKinley Lachenmayr
- Emily Steele McDonough
- Heidi A Oliver
- Todd Rundell
- Speak Life Speech Therapy, LLC
All providers in Kechi, KS · Certified Registered Nurse Anesthetist in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.