Chaquita Henderson, AGPCNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

901493 Issued in MS

Practice address

107 Pine Dr
Hattiesburg, MS 39401-8409

Phone

(601) 434-0960

NPI assigned

Jun 29, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Complete Healthcare Solutions, LLC

  • Primary Care Clinic/Center
  • Hattiesburg, MS
  • NPI 1598560906
  Medicare reassignment NPD Authorized official
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  MS

  Medicare reassignment NPD

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1942651005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 PINE DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394018409",
            "telephone_number": "601-434-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 PINE DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394018409",
            "telephone_number": "601-434-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "CHAQUITA",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MS",
            "license": "901493",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "901493",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "AP08972",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MS",
            "license": "901493",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "LA",
            "license": "AP08972",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MS",
            "license": "901493",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "901493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda M. Heitmuller, LCSW
• Jason D Helton, PT
• Philip C Hemphill, LCSW
• Allison Henderson, PA
• Anita S Henderson, MD
• Charles A Henderson, MD
• Everett Randall Henderson III, M.D.
• James Strong Henderson IV, D.M.D.
• Juliana Cran Henderson, D.M.D. M.S.
• Lanita Henderson, CIDDT

• Psychiatric/Mental Health Nurse Practitioner in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.