Marty Henderson, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

28177570A Issued in IN

Practice address

7150 Clearvista Dr
Indianapolis, IN 46256-1695

Phone

(317) 621-8590

Fax

(317) 621-7884

NPI assigned

May 11, 2006

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mhenderson8598@ecommunitydirect.com

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.

• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244
  Medicare reassignment NPD
• Deaconess Hospital, Inc

  • Hospitalist Physician
  • Evansville, IN
  • NPI 1427097443
  Medicare reassignment NPD
• Iceland Anesthesia Management, LLC

  • Anesthesiology Physician
  • Terre Haute, IN
  • NPI 1912578667

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Community Physicians of Indiana Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD
• Deaconess Hospital Inc

  • Mental Health Counselor
  • Evansville, IN
  • NPI 1508723552
  NPD
• Deaconess Hospital, Inc

  • Anesthesiology Physician
  • Newburgh, IN
  • NPI 1619031416

  Nurse Anesthetist, Certified Registered

  NPD
• Anesthesia Associates P.a.

  • Anesthesiology Physician
  • Boynton Beach, FL
  • NPI 1114965506
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1922058874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7150 CLEARVISTA DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561695",
            "telephone_number": "317-621-8590",
            "fax_number": "317-621-7884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MARTY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP2939972",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28177570A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhenderson8598@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "7150 Clearvista Dr",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462561695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joseph Marvin Henderson, MD
• Keme Henderson, LCSW
• Kyle Henderson
• Leah Marie Henderson, MS
• Madison Henderson
• Rachel Celeste Henderson, APN
• Senetra Henderson
• Stephanie Henderson, DO
• Terry Lynn Henderson, MD
• Tissia Fay Henderson

• Certified Registered Nurse Anesthetist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Certified Registered Nurse Anesthetist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.