BENJAMIN REID HENDERSON (NPI# 1295946564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295946564 |
| Entity Type | Individual |
| Full Name | BENJAMIN REID HENDERSON |
| Credential | M.D. |
| Practice Address |
4801 Ambassador Caffery Pkwy Dept of Radiology Lafayette LA 70508-6917 |
| Mailing Address |
4801 Ambassador Caffery Pkwy Department of Radiology Lafayette LA 70508-6917 |
| Practice Telephone | 3374702180 |
| Mailing Telephone | 3374702180 |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2015-05-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD.202606 | LA | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
MD.202606 | LA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 50964 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881802668 | Benjamin Wallace Henderson | Marriage & Family Therapist | 208 S Balboa Rd, El Paso, TX 79912-5256 | 2007-05-18 |
| 1114129616 | Benjamin Franklin Henderson | Physician Assistant | Inscription House Health Center, Junction Hwy 98and Nav Rte 16, Shonto, AZ 86054 | 2007-06-05 |
| Street Address |
4801 AMBASSADOR CAFFERY PKWY DEPT OF RADIOLOGY |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70508-6917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265437438 | Natalie Breaux Blanchard | Nurse Practitioner | 4801 Ambassador Caffery Pkwy, Lafayette, LA 70508-6917 | 2005-06-15 |
| 1235744566 | Wound Integrity Louisiana Pmc | Family Medicine | 4801 Ambassador Caffery Pkwy, Lafayette, LA 70508-6917 | 2020-09-14 |
| 1487285516 | Emily Nicole Sudduth | Anesthesiology | 4801 Ambassador Caffery Pkwy, Lafayette, LA 70508-6917 | 2020-01-28 |
| 1811555121 | James Matthew Miller | Nurse Practitioner | 4801 Ambassador Caffery Pkwy, Lafayette, LA 70508-6917 | 2019-06-01 |
| 1710541933 | Morgan Ducote Alpha | Nurse Practitioner | 4801 Ambassador Caffery Pkwy, Lafayette, LA 70508-6917 | 2019-04-23 |
| 1801319397 | Chelbie Bell Harris | Occupational Therapist | 4801 Ambassador Caffery Pkwy, Lafayette, LA 70508-6917 | 2017-07-17 |
| 1205372364 | Kathryn Collins | Nurse Anesthetist, Certified Registered | 4801 Ambassador Caffery Pkwy, Lafayette, LA 70508-6917 | 2017-01-13 |
| 1962959080 | Penelope Levie | Nurse Practitioner | 4801 Ambassador Caffery Pkwy, Lafayette, LA 70508-6917 | 2016-09-07 |
| 1144684077 | Rachel Kumar | Hospitalist | 4801 Ambassador Caffery Pkwy, Lafayette, LA 70508-6917 | 2016-04-06 |
| 1104290295 | Amy Green | Nurse Practitioner | 4801 Ambassador Caffery Pkwy, Lafayette, LA 70508-6917 | 2015-11-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
| 1184250607 | Learning Grove Therapy LLC | Clinic/Center | 105 Anaheim Lane, Lafayette, LA 70508 | 2020-03-16 |
| 1780218727 | Jennifer Trumps | Case Manager/Care Coordinator | 200 Entergy Parkway, Lafayette, LA 70508 | 2020-02-28 |
| 1740749605 | Hunter Sy Arceneaux | Physical Therapist | 1700 Kaliste Saloom Road, Building 3, Suite 300, Lafayette, LA 70508 | 2019-03-19 |
| 1295292787 | Brad Michael Gros | Counselor | 160 South Beadle Road, Lafayette, LA 70508 | 2019-02-21 |
| 1205337581 | Alternative Perspectives, LLC | Clinic/Center | 2807 Kaliste Saloom Rd Ste B, Lafayette, LA 70508 | 2018-02-22 |
| 1124528807 | Zachariah James Hebert | Counselor | 1602 W Pinhook Rd Suite 100a, The Family Tree, Lafayette, LA 70508 | 2018-02-19 |
| 1164934477 | Ilyas Munshi, Md Apmc | Non-Pharmacy Dispensing Site | 99 W. Martial Ave, Lafayette, LA 70508 | 2017-10-26 |
| 1447761226 | Louisiana Orthopaedic Specialists, LLC | Durable Medical Equipment & Medical Supplies | 4231 Ambassador Caffery Pkwy, Suite 102, Lafayette, LA 70508 | 2017-10-19 |
| 1306365457 | Mk Dixon Counseling and Consulting | Counselor | 105 Industrial Parkway, Lafayette, LA 70508 | 2017-09-10 |
| Find all providers in zip 70508 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588295448 | Hassan Sawaf | Radiology | 1411 S Creasy Ln Ste 130, Lafayette, IN 47905-7433 | 2020-01-30 |
| 1801383245 | St Marys Imaging Center II | Radiology | 4809 Ambassador Caffery Pkwy Ste 350, Lafayette, LA 70508-8801 | 2018-04-20 |
| 1578937744 | Modesto Radiological Medical Group | Radiology | 2283 Hidden Pond Ln, Lafayette, CA 94549-1742 | 2015-11-25 |
| 1629411210 | Lowell David Froker | Radiology | 32 Olympic Oaks Dr, Lafayette, CA 94549-4800 | 2013-04-12 |
| 1386987196 | Imaging Partners Medical Group | Radiology | 3976 Canyon Rd, Lafayette, CA 94549-2702 | 2013-03-29 |
| 1982946562 | Rachael Lane Guillory | Radiology | 1811 Dulles Dr, Lafayette, LA 70506-3724 | 2013-03-21 |
| 1578811386 | Maurice Louis Bercier | Radiology | 309 Steiner Road, Lafayette, LA 70508 | 2012-08-28 |
| 1295024222 | Lourdes Imaging Center LLC | Radiology | 4809 Ambassador Caffery Parkway, Suite 350, Lafayette, LA 70508 | 2011-03-30 |
| 1467784744 | Delano Zeus Arvin | Radiology | 6233 N 700 E, Lafayette, IN 47905-9761 | 2010-02-11 |
| 1003045287 | Professional Radiology Network Tlc-prn, LLC | Radiology | 107 Kempton Dr, Lafayette, LA 70508-6547 | 2009-07-08 |
| Find all providers in LAFAYETTE | ||||
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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.