Carolyn Jordan Henderson, MD

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

86887 Issued in GA

Practice address

1400 Tullie Rd NE FL 5
Atlanta, GA 30329-2309

Phone

(404) 785-5437

NPI assigned

Mar 22, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Emory Medical Care Foundation Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1063452381
  Medicare reassignment NPD
• Emory Medical Care Foundation Inc

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1225294739
  NPD
• Arthur M. Blank Hospital, Inc.

  • Children's Hospital
  • Atlanta, GA
  • NPI 1689744450
  NPD (past)
• Choa Multispecialty, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1437493467

  Pediatric Pulmonology

  NPD (past)
• Egleston Children'S Hospital at Emory University, Inc.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Atlanta, GA
  • NPI 1558416701
  NPD (past)
• Scottish Rite Children'S Medical Center

  • Pediatric Hematology & Oncology Physician
  • Atlanta, GA
  • NPI 1184779332
  NPD (past)
• Scottish Rite Childrens Medical Ctr

  • Children's Hospital
  • Atlanta, GA
  • NPI 1922178789
  NPD (past)

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1912438839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 TULLIE RD NE FL 5H",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292309",
            "telephone_number": "404-785-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 TULLIE RD NE FL 5",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292309",
            "telephone_number": "404-785-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "CAROLYN",
        "middle_name": "JORDAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "GA",
            "license": "86887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Henderson, ATC, OTC
• Amber Millette Henderson, M.D.
• Angel Henderson
• Aphrodite Henderson
• Candace Deanna Henderson, RN
• Charles Haddon Henderson
• Dana Hughes Henderson, PH.D.
• Darlene Jane Henderson
• David Henderson
• Deasia Diaz Henderson, PA-C

• Pediatric Pulmonology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatric Pulmonology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.