Kimberly Coley Henderson, PHARM.D

Primary specialty

PharmacistTaxonomy code 183500000X

License

17175 Issued in GA

Practice address

1790 Mulkey Rd
Austell, GA 30106-1122

Phone

(770) 693-9388

Fax

(770) 693-9537

NPI assigned

Feb 5, 2021

Last updated

Oct 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kimberly Coley Henderson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Harbor Springs Counseling Services LLC

  • Methadone Clinic
  • Austell, GA
  • NPI 1154889665
  NPD Authorized official
• New Horizons Treatment Center Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rome, GA
  • NPI 1053556365
  NPD Authorized official
• New Start - Mville LLC

  • Methadone Clinic
  • Milledgeville, GA
  • NPI 1548844772
  NPD

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1942892484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 POINTE RIDGE DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303282755",
            "telephone_number": "404-271-8768",
            "fax_number": "404-592-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 MULKEY RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061122",
            "telephone_number": "770-693-9388",
            "fax_number": "770-693-9537"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36 Chateau Ct SE",
            "address_purpose": "LOCATION",
            "city": "Rome",
            "state": "GA",
            "postal_code": "301617264",
            "country_code": "US",
            "telephone_number": "706-233-9603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KIMBERLY",
        "middle_name": "COLEY",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "17175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HENDERSON",
            "middle_name": "COLEY",
            "prefix": "DR.",
            "credential": "PHARM.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Elizabeth Laura Heard, PA-C
• Heart to Heart Companion
• Octavia Moore Hedge, FNP-BC
• Gale Octavia Height
• John W Heisler, PA
• Lauren I Henderson, M.D.
• Amanda Hendricks
• Justin Henry, PMHNP-BC
• Logan Herbert
• Jonathon Brent Herbst, MD

• Pharmacist in Austell, GA
• Providers in Austell, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.