MR. MATTHEW HENDERSON (NPI# 1013568740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013568740 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW HENDERSON |
| Credential | FNP-C |
| Practice Address |
150 Clinic Ave Ste 101 Carrollton GA 30117-4402 |
| Mailing Address |
227 Kramer St Carrollton GA 30117-3705 |
| Practice Telephone | 7708340873 |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2019-09-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN239465 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336623172 | Matthew Gregory Henderson | Physician Assistant | Psc 311, Us Army, Apo, AP 96258 | 2018-09-18 |
| 1831543065 | Matthew Jamal Henderson | Counselor | 6375 S Williamson Blvd, Apt #733, Port Orange, FL 32128-4010 | 2016-04-13 |
| 1790310399 | Matthew Henderson | Counselor | 2615 Edwards St, Alton, IL 62002-3915 | 2020-03-04 |
| 1184150666 | Matthew Scott Henderson | Social Worker | 3155 Mill St Ne, Covington, GA 30014-2542 | 2017-05-03 |
| 1134596901 | Matthew Henderson | Pharmacist | 1026 N Main St, Royal Oak, MI 48067-1317 | 2015-08-28 |
| 1689093379 | Matthew Brandon Henderson | Pediatrics | 2501 N Orange Ave Ste 589, Orlando, FL 32804-4647 | 2014-04-10 |
| 1639438484 | Matthew Henderson | Anesthesiology | 101 W 8th Ave, Spokane, WA 99204-2307 | 2012-05-15 |
| 1629351895 | Matthew David Henderson | Pharmacist | 6435 Aliante Pkwy, North Las Vegas, NV 89084-3196 | 2011-09-23 |
| 1427273879 | Matthew Henderson | Physical Therapist | 4450 Hugh Howell Rd Ste 9, Tucker, GA 30084-4917 | 2007-04-13 |
| 1235280744 | Matthew Morgan Henderson | Social Worker | 1100 Wilford Hall Loop, San Antonio, TX 78236-5638 | 2007-01-13 |
| Street Address |
150 CLINIC AVE STE 101 |
| City | CARROLLTON |
| State | GA |
| Zip Code | 30117-4402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518183789 | Bryan P Kirby | Anesthesiology | 150 Clinic Ave Ste 101, Carrollton, GA 30117-4402 | 2007-04-17 |
| 1033579230 | Carrollton Orthopaedic Clinic PC | Pharmacy | 150 Clinic Ave Ste 101, Carrollton, GA 30117-4402 | 2016-03-01 |
| 1275937054 | Sonia Davis | Registered Nurse | 150 Clinic Ave Ste 101, Carrollton, GA 30117 | 2014-10-22 |
| 1366773590 | Samantha Hammond | Registered Nurse | 150 Clinic Ave Ste 101, Carrollton, GA 30117-4402 | 2010-01-28 |
| 1205071552 | Daniel Lee Maxwell | Orthopaedic Surgery | 150 Clinic Ave Ste 101, Carrollton, GA 30117-4402 | 2008-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1093361404 | Eyedeal Eyecare LLC | Optometrist | 1735 S Us 27, Carrollton, GA 30117 | 2019-08-12 |
| 1710412473 | Janis James | Optometrist | 1735 S, Us-27, Walmart Vision Center, Carrollton, GA 30117 | 2017-05-01 |
| 1568881951 | Omar Hajmurad | Anesthesiology | 812 S Park St Ste 5, Carrollton, GA 30117 | 2014-04-14 |
| 1134550353 | Goodbodys Minor Med Express Care | Nurse Practitioner | 1670 South Park St., Carrollton, GA 30117 | 2013-12-13 |
| 1306187570 | Myriam C Vela-ortiz | Internal Medicine | 157 Clinic Ave Ste 203, Carrollton, GA 30117 | 2013-03-12 |
| 1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
| 1952682486 | Angelic Wings Transport, Inc. | Non-emergency Medical Transport (VAN) | 362 B Columbia Drive, Carrollton, GA 30117 | 2011-08-29 |
| 1073819256 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 812 South Park Street, Suite 2, Carrollton, GA 30117 | 2011-02-04 |
| 1255640348 | Amy Gilbert | Counselor | 515 Tanner St, Carrollton, GA 30117 | 2010-10-06 |
| Find all providers in zip 30117 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841771656 | Sigimol Joseph | Nurse Practitioner | 4541 N Josey Ln Ste 110, Carrollton, TX 75010-4622 | 2018-08-29 |
| 1255678967 | Mariam A Panjwani | Nurse Practitioner | 2304 Janna Way, Carrollton, TX 75006-1509 | 2013-01-15 |
| 1245581602 | Janice May Wilder | Nurse Practitioner | 2183 E Highway 5, Carrollton, GA 30116-7716 | 2012-09-26 |
| 1447393541 | David N Rodriguez | Nurse Practitioner | 2904 Redwood Dr, Carrollton, TX 75007-4839 | 2007-02-15 |
| 1124044029 | Marygrace C Leveille | Nurse Practitioner | 4360 N Josey Ln, Carrollton, TX 75010-4602 | 2006-07-14 |
| 1649737628 | Danyel Kush | Nurse Practitioner | 4100 State Highway 121, Carrollton, TX 75010-1118 | 2019-02-26 |
| 1891265930 | Brinda Matamana | Nurse Practitioner | 4125 Fairway Dr Ste 190, Carrollton, TX 75010-6506 | 2018-12-02 |
| 1033656962 | Amy Hicks | Nurse Practitioner | 714 Cedar St, Carrollton, GA 30117-2415 | 2017-01-30 |
| 1447667696 | Wal-mart Stores East, Lp | Nurse Practitioner | 1735 S Highway 27, Carrollton, GA 30117-8941 | 2014-07-21 |
| 1275945891 | Wal-mart Stores Texas, LLC | Nurse Practitioner | 1213 E Trinity Mills Rd, Carrollton, TX 75006-1446 | 2014-06-02 |
| Find all providers in CARROLLTON | ||||
| City | CARROLLTON |
| Zip Code | 30117 |
Please comment or provide details below to improve the information on MR. MATTHEW HENDERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.