Active NPI
Frederic L Henderson, MD
- Psychiatry Physician
- Metairie, LA
National Provider Identifier
1841207800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD03913R
- Practice address
- 3500 N Causeway Blvd
Ste 1410
Metairie, LA 70002 - Phone
- (504) 838-9919
- Fax
- (504) 834-3101
- NPI assigned
- Aug 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD03913R | LA | Primary |
Addresses
Primary practice location
3500 N Causeway Blvd
Ste 1410
Metairie, LA 70002
Mailing address
3500 N Causeway Blvd
Ste 1410
Metairie, LA 70002
Phone (504) 838-9919
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1315346 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD03913R | LA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325635200000",
"number": "1841207800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 N CAUSEWAY BLVD",
"address_2": "STE 1410",
"city": "METAIRIE",
"state": "LA",
"postal_code": "70002",
"telephone_number": "504-838-9919",
"fax_number": "504-834-3101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 N CAUSEWAY BLVD",
"address_2": "STE 1410",
"city": "METAIRIE",
"state": "LA",
"postal_code": "70002",
"telephone_number": "504-838-9919",
"fax_number": "504-834-3101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "FREDERIC",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2012-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "LA",
"license": "MD03913R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1315346",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Metairie, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.