DR. JEFFREY HARRIS HENDERSON (NPI# 1235386848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1235386848 |
Entity Type | Individual |
Full Name | DR. JEFFREY HARRIS HENDERSON |
Credential | M.D. |
Practice Address |
170 Kimel Park Dr Winston Salem NC 27103-6946 |
Mailing Address |
4601 Park Rd Suite 250 Charlotte NC 28209-3239 |
Practice Telephone | 7043232000 |
Mailing Telephone | (704) 323-2000 |
Enumeration Date | 2008-08-26 |
Last Update Date | 2018-03-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | 2011-00070 | NC | Allopathic & Osteopathic Physicians |
N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
2011-00070 | NC | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | 1497704217 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
445 Pineview Dr, Suite 220, Kernersville, NC 272843817 | 7043232000 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942465026 | Jeffrey Thomas Henderson | Pathology | 1300 N 12th St Ste 300, Phoenix, AZ 85006-2813 | 2008-07-28 |
1194860171 | Jeffrey Henderson | Physical Therapist | 107 Pinkerton Dr, Beaver, PA 15009-1213 | 2007-02-20 |
1598856049 | Jeffrey A. Henderson | Internal Medicine | 3200 Canyon Lake Drive, Rapid City, SD 57702 | 2006-09-28 |
1528026978 | Jeffrey Lynn Henderson | Emergency Medicine | 390 N Main St, Bountiful, UT 84010-6046 | 2006-05-03 |
1912988007 | Jeffrey Mark Henderson | Pediatrics | 430 W Bandera Rd Ste 9, Boerne, TX 78006-2521 | 2005-11-07 |
1578111258 | Jeffrey Lee Henderson Jr. | Pharmacist | 300 W 19th Ter, Kansas City, MO 64108-2026 | 2019-08-27 |
1164994638 | Jeffrey N Henderson | Peer Specialist | 149 W 12th Ave, Eugene, OR 97401-3408 | 2018-12-21 |
1326315185 | Jeffrey Coleman Henderson | Case Manager/Care Coordinator | 5050 Madison Rd, Cincinnati, OH 45227-1491 | 2011-11-22 |
1821173899 | Jeffrey Scott Henderson | Social Worker | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2006-10-26 |
1649354572 | Jeffrey W Henderson | Internal Medicine | 200 Center Street, Ludlow, MA 01056 | 2006-10-25 |
Street Address |
170 KIMEL PARK DR |
City | WINSTON SALEM |
State | NC |
Zip Code | 27103-6946 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306849047 | William Bryan Jennings | Orthopaedic Surgery | 170 Kimel Park Dr, Winston Salem, NC 27103 | 2005-05-26 |
1699388868 | Michael Anthony Walters Jr. | Specialist/Technologist | 170 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2020-08-28 |
1548884992 | Ryan Dula | Occupational Therapist | 170 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2020-06-02 |
1154957983 | Jennifer Baity Hill | Physical Therapist | 170 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2020-03-12 |
1053879502 | Dylan Thomas Plocki | Physician Assistant | 170 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2019-03-04 |
1669939526 | Katherine A Tully | Physical Therapist | 170 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2019-02-27 |
1073007373 | Ann Steber | Occupational Therapist | 170 Kimel Park Dr, Winston Salem, NC 27103 | 2018-06-20 |
1336633106 | Mark Stephen Phillips | Physician Assistant | 170 Kimel Park Dr, Winston Salem, NC 27103 | 2018-06-15 |
1730676081 | Michael Edward Arcuri | Physician Assistant | 170 Kimel Park Dr, Winston Salem, NC 27103 | 2018-04-21 |
1205341419 | Katlyn Marie Joyner | Physician Assistant | 170 Kimel Park Dr, Winston Salem, NC 27103-6946 | 2017-12-11 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
Find all providers in zip 27103 |
Taxonomy Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962048512 | Novant Medical Group, Inc | Family Medicine | 1400 Westgate Ctr Dr Ste 110, Winston Salem, NC 27103-3104 | 2019-11-19 |
1669026456 | Brandon Chase Barnette | Family Medicine | 1825 Denise Ln, Winston Salem, NC 27127-8850 | 2019-07-30 |
1649747999 | Darryl Landis | Family Medicine | 480 Stonegate Ln, Winston Salem, NC 27104-1825 | 2018-10-25 |
1063918670 | Cms Med Health and Wellness Pllc | Family Medicine | 3878 Oxford Station Way, Winston Salem, NC 27103-1340 | 2018-04-03 |
1083069082 | Michael Merz | Family Medicine | Wake Forest Family Medicine Residency, Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2016-04-27 |
1225475023 | Novant Medical Group Inc | Family Medicine | 10479 N Nc Highway 109, 107a, Winston Salem, NC 27107-9643 | 2013-06-03 |
1598028987 | Urgent Cares of America North Carolina Inc. | Family Medicine | 310 S Stratford Rd, Winston Salem, NC 27103-1820 | 2012-06-20 |
1518224617 | Daniel Lewis Myers | Family Medicine | 10479 N Nc Highway 109 Ste 107a, Winston Salem, NC 27107-9884 | 2012-04-13 |
1982989828 | Urgent Cares of America North Carolina Inc | Family Medicine | 4937 Old Country Club Rd., Winston Salem, NC 27104-5068 | 2011-10-11 |
1558657403 | Laura Bartels Torres | Family Medicine | 50 Miller St Ste G, Winston Salem, NC 27104 | 2011-06-20 |
Find all providers in WINSTON SALEM |
City | WINSTON SALEM |
Zip Code | 27103 |
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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.