Deseandra Chanice Henderson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

CP018869T Issued in LA

Practice address

663 Jordan St
Shreveport, LA 71101-4748

Phone

(318) 222-8892

Fax

(318) 222-8893

NPI assigned

Oct 3, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Creighton University School of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthowest, LLCGroup PAC ID 8921086893, 109 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Orthowest LLC

  • Orthopaedic Surgery Physician
  • Omaha, NE
  • NPI 1275641904

  IA, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Orthowest LLC

  • Durable Medical Equipment & Medical Supplies
  • Omaha, NE
  • NPI 1073323606
  NPD
• Select Physical Therapy Texas Limited Partnership

  • Physical Therapy Clinic/Center
  • Houston, TX
  • NPI 1356304323
  NPD (past)

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1861116840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 JORDAN ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014748",
            "telephone_number": "318-222-8892",
            "fax_number": "318-222-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 JORDAN ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014748",
            "telephone_number": "318-222-8892",
            "fax_number": "318-222-8893"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5429 Bowman Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312108903",
            "country_code": "US",
            "telephone_number": "478-219-9673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "DESEANDRA",
        "middle_name": "CHANICE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT016263",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "CP018869T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alecia Monique Henderson, MS, PLPC
• Ashley Henderson
• Cristi N Henderson
• Demetris Henderson
• Derrick L Henderson
• Donna Henderson, LPC
• Doris Henderson, B.S.
• George C Henderson Jr., M.D.
• Ida Natasha Henderson
• Ivonna Henderson

• Physical Therapist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.