Individual provider Active NPI

Mary L Gilbert-Henderson, PHD, LD/N

  • Nutritionist
  • Quincy, FL
National Provider Identifier
1912152117
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
ND2623 Issued in FL
Practice address
2024 PT Milligan Rd
Quincy, FL 32352-5012
Phone
(850) 566-2121
NPI assigned
Dec 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X ND2623 FL Primary

Addresses

Primary practice location

2024 PT Milligan Rd
Quincy, FL 32352-5012

Mailing address

1401 Claude Pichard Dr
Tallahassee, FL 32308-5138
Phone (850) 566-2121

Other names 1

  • Dr. Leah Gilbert-Henderson Other name

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
ND2623FLMDNutritionist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228176000000",
    "number": "1912152117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 CLAUDE PICHARD DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085138",
            "telephone_number": "850-566-2121",
            "fax_number": "850-878-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 PT MILLIGAN RD",
            "city": "QUINCY",
            "state": "FL",
            "postal_code": "323525012",
            "telephone_number": "850-566-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT-HENDERSON",
        "first_name": "MARY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD, LD/N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-02",
        "last_updated": "2008-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "FL",
            "license": "ND2623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "GILBERT-HENDERSON",
            "prefix": "DR.",
            "credential": "PHD, LD/N",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Quincy, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.