Dwayne Henderson

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Practice address

3350 Clara Ave
A
Saint Louis, MO 63120-1634

Phone

(314) 400-8041

NPI assigned

Oct 8, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Elite Home Health, LLC

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1053765032
  NPD (past) Authorized official

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1821469453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5536 HEBERT ST",
            "address_2": "A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631201623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 CLARA AVE",
            "address_2": "A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631201634",
            "telephone_number": "314-400-8041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "DWAYNE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-08",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lourdes Henares-Levy, M.D.
• Jade Henckel
• Amber Marie Henderson, FNP
• Beth A. Henderson, O.D.
• Christine Neou Henderson, M.D.
• Jacqueline Henderson, RN
• Jeffrey Parker Henderson, MD
• Katherine E Henderson, MD
• Kathryn R Henderson, M.D.
• Kristina L Henderson, M.D.

• Home Health Agency in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Home Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.