Jody Widner Henderson, RN-BC

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

RN50310 Issued in TN

Practice address

2018 Western Ave
Knoxville, TN 37921

Phone

(865) 544-0406

Fax

(865) 544-0480

NPI assigned

Mar 13, 2007

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

• Miss Jody Yvonne Widner Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1982737912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 SULPHUR SPRINGS RD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378135654",
            "telephone_number": "423-317-9344",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 WESTERN AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37921",
            "telephone_number": "865-544-0406",
            "fax_number": "865-544-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JODY",
        "middle_name": "WIDNER",
        "name_prefix": "Mrs.",
        "credential": "RN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TN",
            "license": "RN50310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODY",
            "last_name": "WIDNER",
            "middle_name": "YVONNE",
            "prefix": "MISS",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dallas Henderson, MA, LMHC
• Hanna Helich Henderson, FNP-C
• Hope Ann Henderson, O.D.
• Janicia Lelita Henderson, CCMA
• Jennifer Lee Henderson, M.ED, CCC-SLP
• Marissa Henderson
• Melissa Henderson, CNA
• Richard M. Henderson Jr.
• Sacha Henderson, BS
• Vickie L Henderson, LCSW

• Psychiatric/Mental Health Registered Nurse in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Psychiatric/Mental Health Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; 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.