Charles Montgomery Henderson, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT008435 Issued in GA

Practice address

1111 Glynco Pkwy Ste 110
Brunswick, GA 31525-7922

Phone

(912) 264-5377

NPI assigned

Jan 26, 2007

Last updated

Jul 8, 2007By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922154418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 WELLINGTON PL",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315237075",
            "telephone_number": "912-262-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 GLYNCO PKWY STE 110",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315257922",
            "telephone_number": "912-264-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "CHARLES",
        "middle_name": "MONTGOMERY",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shannon Jean Hemenway, APRN, ANP-BC
• Sam Reynolds Hendley Jr., RPH
• Mary Allison Hendrickson-Quirk, D.O.
• Angela Stephen Hennessee, MSN APRN PMHNP
• Audrey E Herbert, DPT
• Donna Hermida, RN

• Physical Therapist in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.