Jacob Henderson, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

2305212743 Issued in VA

Practice address

2106 Executive Dr
Hampton, VA 23666-2402

Phone

(757) 838-6678

Fax

(757) 838-8116

NPI assigned

May 17, 2019

Sex

Male

Sole proprietor

No

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)

Enrolled

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1891351649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7121 NEWPORT AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235053924",
            "telephone_number": "567-249-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 EXECUTIVE DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662402",
            "telephone_number": "757-838-6678",
            "fax_number": "757-838-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JACOB",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-17",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "VA",
            "license": "2305212743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helping Hands of Williamsburg, LLC
• Helping Others Prosper Effectively Enterprise LLC
• Helping People Overcome Problems With Empowerment, LLC (Hope LLC)
• Kyle S Helwig, LPC
• Glori Mae Henderson, QMHP,ADMINISTRATOR
• Joan Henderson
• Shirelle Hendrick, LCSW
• Joelle L.M Hendrickson-Hairston, DDS
• McKenzie O Henry, COTA/L
• Michael George Henry, LPN

• Orthopedic Physical Therapist in Hampton, VA
• Providers in Hampton, VA by specialty
• Orthopedic Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; 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.