Rebecca Gagne Henderson, PHD, NP-C FNP ACHPN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4925 Issued in CT

Practice address

1579 Straits Tpke Ste 1E
Middlebury, CT 06762-1835

Phone

(203) 490-1000

NPI assigned

Jul 20, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Rebecca Gagne-Henderson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Interoperability endpoints

• Direct secure messaging: rgagnehenderson81277@middlesexhealthprd.direct-ci.com
• Direct secure messaging: rgagnehenderson100483@direct.ynhh.org

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.

• Saint Raphael Faculty Physicians

  • Internal Medicine Physician
  • New Haven, CT
  • NPI 1932138138
  NPD (past)
• Seasons Hospice & Palliative Care of Connecticut, LLC

  • Community Based Hospice Care Agency
  • Middlebury, CT
  • NPI 1669726477
  NPD (past)

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

{
    "created_epoch": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1851521215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 SHAFER CT STE 700",
            "city": "ROSEMONT",
            "state": "IL",
            "postal_code": "600184989",
            "telephone_number": "346-376-1702",
            "fax_number": "224-532-2780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1579 STRAITS TPKE STE 1E",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621835",
            "telephone_number": "203-490-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNE HENDERSON",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "PHD, NP-C FNP ACHPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-20",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "4925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "GAGNE-HENDERSON",
            "credential": "PHD,  NP-C FNP ACHPN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Stanley J Foster III, M.D.
• Emily Grace Fritz, LCSW
• Full Circle Counseling, LLC
• Pinky Gaba, APRN, FNP
• Victoria Belle Gagas
• John Robert Gagne, DDS
• Bryan J Garcia
• GHJR Counseling LLC
• GHJR Counseling LLC
• Laura Gilland, LPC, NCC

• All providers in Middlebury, CT
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.