JACQUELINE HENDERSON (NPI# 1366482358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366482358 |
| Entity Type | Individual |
| Full Name | JACQUELINE HENDERSON |
| Credential | MD |
| Practice Address |
301 W Homer St Michigan City IN 46360-4358 |
| Mailing Address |
2000 Green Rd Suite 300 Ann Arbor MI 48105-1598 |
| Practice Telephone | 2198798511 |
| Mailing Telephone | 7349953764 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2008-06-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
01059200A | IN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366851925 | Jacqueline Henderson | Contractor | 1601 Crabapple Cove Ct N, Jacksonville, FL 32225-2500 | 2014-08-07 |
| 1669035846 | Jacqueline Henderson | Registered Nurse | 1501 Madison Rd, Walnut Hills, OH 45206-1706 | 2019-04-15 |
| 1700382041 | Jacqueline Henderson | Technician | 1215 49th St Ne, Washington, DC 20019-3937 | 2018-04-04 |
| 1801131560 | Jacqueline Henderson | Counselor | 3204 E Moore Ave, Searcy, AR 72143-4826 | 2012-12-06 |
| 1851600233 | Jacqueline Henderson | Registered Nurse | 4219 Laclede Ave, Suite B, Saint Louis, MO 63108-2814 | 2010-10-01 |
| 1033366331 | Jacqueline A Henderson | Physical Therapist | 110 E 42nd St, Suite 1504, New York, NY 10017-5611 | 2008-08-19 |
| Street Address |
301 W HOMER ST |
| City | MICHIGAN CITY |
| State | IN |
| Zip Code | 46360-4358 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154320406 | Christy Berrier | Dietitian, Registered | 301 W Homer St, Michigan City, IN 46360-4358 | 2005-07-19 |
| 1962973057 | Kevin Sison | Physical Therapist | 301 W Homer St, Michigan City, IN 46360-4358 | 2018-12-16 |
| 1255809844 | William Charles Geegan Sahy | Pharmacist | 301 W Homer St, Michigan City, IN 46360-4358 | 2018-11-13 |
| 1568907483 | James Safrithis | Nurse Anesthetist, Certified Registered | 301 W Homer St, Michigan City, IN 46360-4358 | 2017-01-02 |
| 1609237585 | Jeffrey Taylor | Occupational Therapy Assistant | 301 W Homer St, Michigan City, IN 46360-4358 | 2016-03-18 |
| 1003275702 | Marietta Meuli | Specialist/Technologist | 301 W Homer St, Michigan City, IN 46360-4358 | 2016-02-23 |
| 1215396908 | Terry Harris | Physical Therapy Assistant | 301 W Homer St, Michigan City, IN 46360-4358 | 2016-02-23 |
| 1770942484 | Jami Ott | Physical Therapy Assistant | 301 W Homer St, Michigan City, IN 46360-4358 | 2016-02-23 |
| 1346609021 | Eileen Haas | Physical Therapy Assistant | 301 W Homer St, Michigan City, IN 46360-4358 | 2016-02-23 |
| 1235598947 | Zachary Ornelas | Specialist/Technologist | 301 W Homer St, Michigan City, IN 46360-4358 | 2016-02-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821649096 | Trinity Healthcare Inc. | Occupational Therapist | 4300 Cleveland Ave, Michigan City, IN 46360 | 2019-09-27 |
| 1861905499 | Erika Leigh Maroon | Chiropractor | 8690 West Pahs Rd., Michigan City, IN 46360 | 2017-11-06 |
| 1750740650 | Michelle Asbell | Nurse Practitioner | 301 Homer St, Michigan City, IN 46360 | 2016-02-19 |
| 1235523952 | Marnee Flinn-smith | Specialist/Technologist | 8466 Pahs Rd, Michigan City, IN 46360 | 2015-03-19 |
| 1184976359 | Kelly Stewart | Physical Therapist | 301 Homer Street, Michigan City, IN 46360 | 2012-10-11 |
| 1053660936 | Planned Parenthood of Indiana Michigan City | Clinic/Center | 324 Dunes Plaza, Michigan City, IN 46360 | 2012-09-06 |
| 1114288644 | June R. R. Nichols Ocularist, Ltd | Durable Medical Equipment & Medical Supplies | 450 St. John Road, Suite 396, Michigan City, IN 46360 | 2012-05-31 |
| 1083980858 | Enoch Kassa | Internal Medicine | 3777 N Frontage Rd, Michigan City, IN 46360 | 2012-03-27 |
| 1760768196 | American Limb & Orthopedic Company of Valparaiso | Prosthetic/Orthotic Supplier | 3777 N. Frontage Rd, Suite 100, Michigan City, IN 46360 | 2011-10-31 |
| 1801181144 | Elizabeth A Whitaker | Counselor | 8733 W. 400 N., 400 North Medical Center, Michigan City, IN 46360 | 2011-06-15 |
| Find all providers in zip 46360 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053418442 | Willie F Stewart | Emergency Medicine | 301 W Homer St, Michigan City, IN 46360-4358 | 2006-09-20 |
| 1194764647 | Diane S Wallace | Emergency Medicine | 301 W Homer St, Michigan City, IN 46360-4358 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346871217 | Nw Indiana Ep, LLC | Emergency Medicine | 7904 Cabela Dr, Hammond, IN 46324-2950 | 2020-01-30 |
| 1801383278 | Midwest Emergency Medicine, Inc. | Emergency Medicine | 520 S 7th Street, Er, Vincennes, IN 47591-1038 | 2018-04-20 |
| 1285994434 | Aaron Brooks Crofoot | Emergency Medicine | 229 W North Shore Dr, South Bend, IN 46617-1142 | 2012-05-22 |
| 1689842262 | James Scott Frasure | Emergency Medicine | 4030 W Breezewood Ct, Bloomington, IN 47404-9132 | 2008-02-15 |
| 1831290956 | Suzanne M Coleman | Emergency Medicine | 3124 E State Blvd Ste 2b, Fort Wayne, IN 46805-4763 | 2006-09-25 |
| 1194772681 | Paula Lange | Emergency Medicine | 3252 Tantara Bnd, Carmel, IN 46032-8733 | 2006-05-28 |
| 1982658886 | Robert L Goddard Jr. | Emergency Medicine | 817 W Rosewood Dr, Bloomington, IN 47404-1849 | 2006-05-22 |
| 1295796985 | Thomas S Spencer | Emergency Medicine | 104 E Culver Rd, Suite 103, Knox, IN 46534-2216 | 2006-03-31 |
| 1609844166 | Joseph V Lazzara | Emergency Medicine | 8633 N State Road 550, Bruceville, IN 47516-6096 | 2006-03-10 |
| 1427048099 | Mark M Walsh | Emergency Medicine | 801 E Lasalle, Emergency Department, South Bend, IN 46617-2814 | 2005-10-25 |
| Find all providers with the same taxonomy | ||||
| City | MICHIGAN CITY |
| Zip Code | 46360 |
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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.