Individual provider Active NPI

Zachary Henderson, FNP

  • Family Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1942719240
Registry record updated Sep 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2306007 Issued in MA
Practice address
100 Institute Rd
Worcester, MA 01609-2247
Phone
(508) 831-5520
NPI assigned
Sep 29, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2306007 MA Primary

Addresses

Primary practice location

100 Institute Rd
Worcester, MA 01609-2247

Mailing address

100 Institute Rd
Worcester, MA 01609-2247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20180507000889 MA Practitioner - Nurse Practitioner 4880958438 Reassigns benefits to 2 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
Heywood Medical Group Inc.Group PAC ID 6901882836, 111 clinicians

Practice addresses (Care Compare)

266 Main St
Gardner, MA 01440-2927
Phone (978) 630-5030

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2306007MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heywood Medical Group Inc. Family CurrentSince May 1, 2018 Accepting new patients
Athol Memorial Hospital Incorporated Family CurrentSince May 1, 2018 Accepting new patients
Heywood Affiliated Medical Group Inc. CurrentSince May 1, 2018 Accepting new patients

Locations

61 Main St
Ashburnham, MA 01430
Phone (978) 827-3115

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

250 Green St
Gardner, MA 01440
Phone (978) 630-5050

242 Green St
Ste 205
Gardner, MA 01440

266 Main St
Gardner, MA 01440
Phone (978) 630-5030

Interoperability endpoints

  • Direct secure messaging: zachary.henderson.1@192.direct.athenahealth.com

Organizations & group practices 3

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 4

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": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506643200000",
    "number": "1942719240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 INSTITUTE RD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 INSTITUTE RD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092247",
            "telephone_number": "508-831-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ZACHARY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-29",
        "last_updated": "2017-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2306007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.