Peter L Henderson Jr., MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

27386 Issued in GA

Practice address

106 Hospital Dr
Suite 6
Chatsworth, GA 30705-2070

Phone

(706) 695-9240

Fax

(706) 695-9241

NPI assigned

Sep 25, 2006

Last updated

Nov 8, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Progress Weight Loss, PC

  dba Progress Weight Loss Surgery

  • Surgery Physician
  • Raleigh, NC
  • NPI 1942524129
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1902906084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12938",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307037013",
            "telephone_number": "706-602-7800",
            "fax_number": "706-879-5843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 HOSPITAL DR",
            "address_2": "SUITE 6",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307052070",
            "telephone_number": "706-695-9240",
            "fax_number": "706-695-9241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "PETER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "27386",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2010-00324",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP #",
            "identifier": "GRP4720",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cody Wayne Hammett, RPH
• Jennifer Arden Hammontree, PHARMD
• Andrew Hawkins, O.D.
• Kaitlin Mayo Hawkins, O.D.
• Halle Poteet Heiner
• Wendi Jennings Hendrix, RPH
• Kimberly Adriana Hernandez Cardoza
• Keisha Hernandez
• Highland Rivers Community Service Board
• Highland Rivers Community Service Board

• Surgery Physician in Chatsworth, GA
• Providers in Chatsworth, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.