MR. RUSSELL LOYD HENDERSON (NPI# 1336486943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336486943 |
| Entity Type | Individual |
| Full Name | MR. RUSSELL LOYD HENDERSON |
| Credential | FNP-BC |
| Practice Address |
595 Sw Bluff Dr Ste A Bend OR 97702 |
| Mailing Address |
Po Box 70673 Springfield OR 97475-0133 |
| Practice Telephone | 5417282063 |
| Mailing Telephone | 5412489556 |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2018-07-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
201401588NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1800 Coburg Rd, Eugene, OR 974014995 | 5412553233 | |
| 320 N Madison, Pittsfield, IL 62363 | 2172859601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538366000 | Russell Lee Henderson | Social Worker | 175 Emery Hwy, Macon, GA 31217-3692 | 2007-06-28 |
| Street Address |
595 SW BLUFF DR STE A |
| City | BEND |
| State | OR |
| Zip Code | 97702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083789747 | Michael D Tobey | Chiropractor | 595 Sw Bluff Dr Ste A, Bend, OR 97702-1283 | 2006-11-21 |
| 1356848352 | Omhc, LLC | Clinic/Center | 595 Sw Bluff Dr Ste A, Bend, OR 97702-1283 | 2018-04-07 |
| 1265940308 | Monarch Medical Group LLC | Clinic/Center | 595 Sw Bluff Dr Ste A, Bend, OR 97702-1283 | 2018-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629676259 | Amy Michelle Anderson | Counselor | 233 Sw Wilson Ave, Ste 201, Bend, OR 97702 | 2020-10-15 |
| 1386259463 | Jacob Rehder | Counselor | 19717 Mt Batchelor Dr, #226, Bend, OR 97702 | 2020-09-15 |
| 1497385215 | Capacity Performance Therapy | Physical Medicine & Rehabilitation | 61125 Lodgepole Dr., Bend, OR 97702 | 2020-01-21 |
| 1962041707 | Shift Bend Functional Medicine | Family Medicine | 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 | 2019-12-26 |
| 1609435049 | Praxis Medical Group Inc | Orthopaedic Surgery | 1140 Sw Simpson Avenue, Suite 100, Bend, OR 97702 | 2019-06-10 |
| 1013485754 | Elana Leah Pesah | Social Worker | 138 Maaglei Harim Levin, Jerusalem, ISRAEL 97702 | 2018-11-12 |
| 1104303239 | Kyleigh Mcvey | Massage Therapist | 999 Sw Disk Dr, Bend, OR 97702 | 2018-07-21 |
| 1477042869 | Siloe Castaneda Huerta | Counselor | 1340 Nw Wall, Bend, Or, Bend, OR 97702 | 2018-05-02 |
| 1164910808 | Rebecca M Joyce | Social Worker | 1011 Sw Emkay Dr. Suite 101, Bend, OR 97702 | 2018-04-27 |
| 1093217978 | Jennifer Bury | Acupuncturist | 296 Sw Columbia St Ste D1, Bend, OR 97702 | 2018-03-06 |
| Find all providers in zip 97702 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376863613 | Susan Hart | Nurse Practitioner | 62168 Ob Riley Rd E2-16, Bend, OR 97701 | 2010-06-09 |
| 1558689836 | Amy Kreutzer Erber | Nurse Practitioner | 151 Sw Shevlin Hixon Dr Ste 2, Bend, OR 97702-3209 | 2010-05-11 |
| 1962674887 | Tricia Lynne Couture | Nurse Practitioner | 19790 Dry Canyon Ave, Bend, OR 97702-3034 | 2008-04-01 |
| 1043405699 | Roxanne Marie Hanington | Nurse Practitioner | 285 Nw Scenic Heights Dr, Bend, OR 97701-7548 | 2007-09-06 |
| 1952311003 | Karyn Anderson | Nurse Practitioner | 726 Nw Wall Street, Bend, OR 97701 | 2006-08-09 |
| 1053336990 | Lee Anne Hellesto | Nurse Practitioner | 888 Nw Hill St Ste 3, Bend, OR 97703-2942 | 2006-07-13 |
| 1932175718 | Karen Lynn Harding | Nurse Practitioner | 2577 Ne Courtney Dr, Suite 300, Bend, OR 97701 | 2006-02-23 |
| 1841277480 | Michelle A Wright | Nurse Practitioner | 61250 Se Coombs Pl, Bend, OR 97702-3704 | 2005-12-25 |
| 1043294911 | Helen Wylie Poindexter | Nurse Practitioner | 18 Nw Oregon Ave, Bend, OR 97701-2729 | 2005-12-02 |
| 1003890351 | Thomas Eugene Coehlo | Nurse Practitioner | 2190 Ne Professional Ct, Suite 250, Bend, OR 97701-6985 | 2005-11-30 |
| Find all providers in BEND | ||||
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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.