Active NPI
Alvin Allen Henderson, DC
- Chiropractor
- Bastrop, LA
National Provider Identifier
1891722567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1147
- Practice address
- 1115 McCreight St
Bastrop, LA 71220-3241 - Phone
- (318) 281-2992
- Fax
- (318) 281-2994
- NPI assigned
- Jun 27, 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1147 | LA | Primary |
Addresses
Primary practice location
1115 McCreight St
Bastrop, LA 71220-3241
Mailing address
1115 McCreight St
Bastrop, LA 71220-3241
Phone (318) 281-2992
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G0344 | Other | LA | BLUE CROSS BLUE SHILED |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891722567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1115 MCCREIGHT ST",
"city": "BASTROP",
"state": "LA",
"postal_code": "712203241",
"telephone_number": "318-281-2992",
"fax_number": "318-281-2994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 MCCREIGHT ST",
"city": "BASTROP",
"state": "LA",
"postal_code": "712203241",
"telephone_number": "318-281-2992",
"fax_number": "318-281-2994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "ALVIN",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "LA",
"license": "1147",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHILED",
"identifier": "G0344",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bastrop, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.