Kenya Henderson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

741 Issued in MS

Practice address

2600 McIngvale Rd
Hernando, MS 38632-8658

Phone

(662) 429-7099

Fax

(662) 449-3021

NPI assigned

Feb 16, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Henderson Vision Center

  • Optometrist
  • Hernando, MS
  • NPI 1306931597
  NPD Authorized official
• Wal-Mart Stores East, LP

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1972647519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 MCINGVALE RD",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386328658",
            "telephone_number": "662-429-7099",
            "fax_number": "662-449-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 MCINGVALE RD",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386328658",
            "telephone_number": "662-429-7099",
            "fax_number": "662-449-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KENYA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2618",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02450266",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Harrell, NP
• Claire Bostwick Harris, PHARM D
• Brittany Hawkins, COTA/L
• Hearing Solutions LLC
• Henderson Vision Center
• Henry Health & Wellness, LLC
• Hernando Dental Group Incorporated
• Hernando Family Chiropractic, LLC
• Hernando Psychiatry LLC
• Hunter Hill

• Optometrist in Hernando, MS
• Providers in Hernando, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.

Verify at the official NPI Registry.