Individual provider Active NPI

Paula Henderson, FNP

  • Family Medicine Physician
  • Fort Payne, AL
National Provider Identifier
1912470824
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2017033470 Issued in AL
Practice address
1906 Glenn Blvd SW Ste 100a
Fort Payne, AL 35968-2406
Phone
(256) 638-4411
Fax
(256) 638-9275
NPI assigned
Jan 3, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2017033470 AL Primary

Addresses

Primary practice location

1906 Glenn Blvd SW Ste 100a
Fort Payne, AL 35968-2406

Mailing address

1906 Glenn Blvd SW Ste 100a
Fort Payne, AL 35968
Phone (256) 638-4411

Other names 1

  • Ms. Paula Henderson Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190425001109 AL Practitioner - Nurse Practitioner 5496097339 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faith Medical Clinic LLCGroup PAC ID 8022429208, 2 clinicians

Practice addresses (Care Compare)

1906 Glenn Blvd SW
Suite 100a
Fort Payne, AL 35968-3545
Phone (256) 638-4411

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Rainbow City, AL, CCN 017018
  • Enhabit Home Health Home health agency, Hoover, AL, CCN 017009
  • Dekalb Regional Medical Center Hospital, Fort Payne, AL, CCN 010012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2017033470ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sherrill Holdings, Inc CurrentSince Mar 1, 2019 Accepting new patients
Faith Medical Clinic LLC CurrentSince Apr 1, 2020 Accepting new patients
Family First Medicine LLC Family Medicine CurrentSince Aug 7, 2019 Accepting new patients
Family First Medicine LLC Family Medicine Past Accepting new patients

Locations

1906 Glenn Blvd SW
Ste 100
Fort Payne, AL 35968

1906 Glenn Blvd SW
Ste 100A
Fort Payne, AL 35968
Phone (256) 638-4411

1202 Gault Ave N
Fort Payne, AL
Phone (256) 273-6827

504 McCurdy Ave S
#6
Rainsville, AL 35986
Phone (256) 638-9161

1601 Veterans Dr
Ste 102
Scottsboro, AL 35769
Phone (256) 638-9161

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15538/brand/2/csg/1/fhir/r4
  • Direct secure messaging: paula.henderson.1@29891.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Faith Medical Clinic LLCRainsville, AL, CCN 018958 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)
Operational/Managerial Control (100%)
Apr 1, 2020
Apr 1, 2020
Apr 1, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1912470824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 GLENN BLVD SW STE 100A",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "35968",
            "telephone_number": "256-638-4411",
            "fax_number": "256-638-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 GLENN BLVD SW STE 100A",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359682406",
            "telephone_number": "256-638-4411",
            "fax_number": "256-638-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "PAULA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-03",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "2017033470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULA",
            "last_name": "HENDERSON",
            "prefix": "MS.",
            "credential": "NURSE PRACTITIONER",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Payne, AL

Sources for this page

Verify at the official NPI Registry.