Walter E. Henderson Jr., D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

001443 Issued in CT

Practice address

1101 Farmington Ave
Berlin, CT 06037-2241

Phone

(860) 828-8220

Fax

(860) 828-8232

NPI assigned

Jan 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Henderson Family Chiropractic LLC

  • Chiropractor
  • Berlin, CT
  • NPI 1265725899
  Medicare reassignment NPD Authorized official
• Psychological Services of Kensington, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Berlin, CT
  • NPI 1073012597
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1801945548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1097 FARMINGTON AVE",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060372241",
            "telephone_number": "860-828-8220",
            "fax_number": "860-828-8232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 FARMINGTON AVE",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "060372241",
            "telephone_number": "860-828-8220",
            "fax_number": "860-828-8232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "WALTER",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "001443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "47-0862263",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "47-0862263",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "47-0862263",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH",
            "identifier": "P2811446",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "050001443CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carrie M Hartney, DC
• Haven Help Inc
• Healing Connections Wellness LLC
• Henderson Family Chiropractic LLC
• Kimberly Henderson-Kjellen, PSYD
• Courtney Higgins, LMSW
• Leah Hinchliffe
• Holistic Healing Therapy & Coaching LLC
• Homecare Associates LLC
• Elizabeth Mary Hrubiec Retano

• All providers in Berlin, CT
• Chiropractor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.