Henderson Wellness Center, PA

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

25053 Issued in NC

Legal business name

HENDERSON WELLNESS CENTER, PA

Practice address

414 Dabney Dr
Henderson, NC 27536-3944

Phone

(252) 430-8000

Fax

(252) 430-8200

NPI assigned

Sep 26, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Dennis Michael Mahan, M.D.

Title

Doctor

Phone

(252) 430-8000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222387200000",
    "number": "1902056948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 DABNEY DR",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275363944",
            "telephone_number": "252-430-8000",
            "fax_number": "252-430-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 DABNEY DR",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275363944",
            "telephone_number": "252-430-8000",
            "fax_number": "252-430-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON WELLNESS CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-26",
        "last_updated": "2008-09-26",
        "status": "A",
        "authorized_official_last_name": "MAHAN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "252-430-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NC",
            "license": "25053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8953753",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Henderson Clinic for Women PA
• Henderson Emergency Physicians, PLLC
• Henderson Operator LLC
• Henderson Pulmonary & Sleep Medicine, PLLC
• Henderson SCH Operating LLC
• Henderson/Vance Healthcare, Inc.
• Henderson/Vance Healthcare, Inc.
• Henderson/Vance Healthcare, Inc.
• Cheryl Harris Hester, FNP
• Sandra Hicks, LCASA

• Multi-Specialty Clinic/Center in Henderson, NC
• Providers in Henderson, NC by specialty
• Multi-Specialty Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; 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.