GEORGE C HENDERSON JR. (NPI# 1285650713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285650713 |
| Entity Type | Individual |
| Full Name | GEORGE C HENDERSON JR. |
| Credential | M.D. |
| Practice Address |
1625 David Raines Rd Shreveport LA 71107-5899 |
| Practice Telephone | 3188416048 |
| Practice Fax Number | 3188416044 |
| Mailing Telephone | 3188416048 |
| Mailing Fax Number | 3188416044 |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2011-10-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 013310 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1190519 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215985957 | George Patrick Henderson | Otolaryngology | 115 Highland Rd, Southern Pines, NC 28387-5725 | 2006-05-05 |
| 1811101918 | George O Henderson | Dentist | 1241 S Taylor St, Fallon, NV 89406-5804 | 2007-05-09 |
| Street Address |
1625 DAVID RAINES RD |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71107-5899 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558386847 | David Joseph Bellew | Dentist | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2006-07-13 |
| 1558918722 | Bisi Joseph Ekundayo | Dentist | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2019-08-22 |
| 1144705930 | David Raines Community Health Center Inc | Clinic/Center | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2018-09-27 |
| 1871019406 | Shamika Nicole Calhoun | Nurse Practitioner | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2017-08-15 |
| 1114472875 | Dana Sumbler | Nurse Practitioner | 1625 David Raines Rd, Shreveport, LA 71107-2712 | 2016-08-23 |
| 1245531987 | Alexandra K Drake | Nurse Practitioner | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2010-11-11 |
| 1508178559 | Benjamin Joseph Bumgardner | Dentist | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2010-07-07 |
| 1245560879 | Magdalyn A Thomas | Dentist | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2010-01-04 |
| 1821228909 | Pratibha Anne | Family Medicine | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2009-07-22 |
| 1487880407 | Sadaf Javaid | Psychiatry & Neurology | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2009-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306490875 | Kimber Leigh Lumley | Registered Nurse | 1440 Hawn Ave., Shreveport, LA 71107 | 2019-08-01 |
| 1871063461 | Nicole Capito | Case Manager/Care Coordinator | 200 North Thomas Drive Ste 1, Shreveport, LA 71107 | 2018-11-27 |
| 1891260899 | Danielle Leigh Dreher | Dental Assistant | 3610 Gorman Rd, Shreveport, LA 71107 | 2018-10-05 |
| 1255817540 | Shirley Marie Washington | Technician | 3227 Old Mooringsport Rd., Shreveport Rd, LA 71107 | 2018-07-19 |
| 1366928467 | Katrina L Bailey | Case Manager/Care Coordinator | 1111 Hawn Ave Apt A, Shreveport, LA 71107 | 2018-07-12 |
| 1063907970 | James Mcneely IIi | Public Health or Welfare | 5922 Alaska Ln, Shreveport, LA 71107 | 2018-06-25 |
| 1528560067 | Jacarie Guice | Case Manager/Care Coordinator | 4601 N. Market Ste 2, Shreveport, LA 71107 | 2018-03-01 |
| 1467971069 | Tracy Renard Harris | Counselor | 1149 Englemeade Dr, Shreveport, LA 71107 | 2017-09-14 |
| 1427588045 | Mark Rogers | Behavior Technician | 1500 N. Market Unit C Suite 105, Shreveport, LA 71107 | 2017-06-15 |
| 1356871164 | Hope4youth | Voluntary or Charitable | 2850 King Oaks Loop, Shreveport, LA 71107 | 2017-06-14 |
| Find all providers in zip 71107 | ||||
| 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 |
|---|---|---|---|---|
| 1922621390 | Partners In Primary Care La PC | Family Medicine | 7551 Youree Dr Ste 11, Shreveport, LA 71105-5533 | 2020-05-20 |
| 1528609104 | Spectra Family Clinic, LLC | Family Medicine | 9300 Mansfield Rd Ste 209, Shreveport, LA 71118-3138 | 2019-10-04 |
| 1922502327 | Courtney Morgan | Family Medicine | 723 Milam St, Shreveport, LA 71101-3507 | 2018-03-20 |
| 1174973317 | Patrick Michael Fitz-gerald | Family Medicine | 731 Coachlight Rd, Shreveport, LA 71106-7205 | 2016-06-19 |
| 1437446341 | Samreena N Sara | Family Medicine | 8835 Line Ave Ste 400a, Shreveport, LA 71106-6722 | 2011-06-30 |
| 1932490554 | Michael Thomas Kitchell | Family Medicine | 1666 E Bert Koun Loop Ste 105, Shreveport, LA 71105-5718 | 2011-04-30 |
| 1831402254 | David J. Colvin Md LLC | Family Medicine | 148 Waters Edge Dr, Shreveport, LA 71106-7774 | 2010-07-15 |
| 1952628802 | Tri Pham | Family Medicine | 133 Charles Ave, Shreveport, LA 71105-3719 | 2010-04-30 |
| 1669799524 | Stephanie James | Family Medicine | 2120 Bert Kouns Industrial Loop Ste M, Shreveport, LA 71118-3355 | 2010-04-30 |
| 1205062965 | Charles Henry Nash | Family Medicine | 5935 Gilbert Dr, Shreveport, LA 71106-2315 | 2009-06-08 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71107 |
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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.