Active NPI
Bridgette L Henderson, NP
- Gerontology Nurse Practitioner
- Marlton, NJ
National Provider Identifier
1962530113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 26NN10905100
- Practice address
- 99 E Main St
Marlton, NJ 08053-2122 - Phone
- (856) 983-0411
- NPI assigned
- Mar 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 26NN10905100 | NJ | Primary |
Addresses
Primary practice location
99 E Main St
Marlton, NJ 08053-2122
Mailing address
99 E Main St
Marlton, NJ 08053-2122
Phone (856) 983-0411
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8571007 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
99 E Main St
Marlton, NJ 08053-2122
Phone (856) 983-0411
Hospital & facility affiliations
- Wiley Mission
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Organizations & group practices 1
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.
-
- Skilled Nursing Facility
- Marlton, NJ
- NPI 1821126541
Hospital & facility affiliations 1
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": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962530113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 E MAIN ST",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080532122",
"telephone_number": "856-983-0411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 E MAIN ST",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080532122",
"telephone_number": "856-983-0411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "BRIDGETTE",
"middle_name": "L",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "NJ",
"license": "26NN10905100",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8571007",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marlton, NJ
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.