Active NPI
Stephen Henderson, RPH
- Pharmacist
- Clanton, AL
National Provider Identifier
1902111529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9797
- Practice address
- 1010 Lay Dam Rd
Clanton, AL 35045-2306 - Phone
- (205) 280-3529
- NPI assigned
- Aug 9, 2010
- Last updated
- Apr 5, 2012
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9797 | AL | Primary |
Addresses
Primary practice location
1010 Lay Dam Rd
Clanton, AL 35045-2306
Mailing address
1509 Blind Brook LN
Vestavia, AL 35216-3304
Phone (205) 979-8811
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)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9797 | AL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333584000000",
"number": "1902111529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1509 BLIND BROOK LN",
"city": "VESTAVIA",
"state": "AL",
"postal_code": "352163304",
"telephone_number": "205-979-8811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 LAY DAM RD",
"city": "CLANTON",
"state": "AL",
"postal_code": "350452306",
"telephone_number": "205-280-3529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "STEPHEN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-09",
"last_updated": "2012-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "9797",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clanton, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.