NPIMap

Organization Active NPI

Nanine S Henderson DO

  • Addiction Medicine (Family Medicine) Physician
  • Louisville, KY
National Provider Identifier
1821254145
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
NANINE S HENDERSON DO
Practice address
4010 Dupont Cir
Suite 200
Louisville, KY 40207-4812
Phone
(502) 893-5422
Fax
(502) 896-4962
NPI assigned
Aug 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Authorized official

Name
Nanine Scot Henderson, DONPI 1376617183
Title
Physician
Phone
(502) 893-5422

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X Primary

Addresses

Primary practice location

4010 Dupont Cir
Suite 200
Louisville, KY 40207-4812

Mailing address

4010 Dupont Cir
Suite 200
Louisville, KY 40207-4812
Phone (502) 893-5422

Other names 1

  • nanine s henderson do Former legal business name

National Provider Directory

National Provider Directory

Locations

4010 DuPont Cir
Ste 200
Louisville, KY 40207
Phone (502) 893-5422

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1821254145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR",
            "address_2": "SUITE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074812",
            "telephone_number": "502-893-5422",
            "fax_number": "502-896-4962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR",
            "address_2": "SUITE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074812",
            "telephone_number": "502-893-5422",
            "fax_number": "502-896-4962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANINE S HENDERSON DO",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-06",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "NANINE",
        "authorized_official_middle_name": "SCOT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "502-893-5422",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "nanine s henderson do",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; 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.