AUDREY HENDERSON M.D.P.C. (NPI# 1386825222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386825222 |
| Entity Type | Organization |
| Organization Name | AUDREY HENDERSON M.D.P.C. |
| Practice Address |
2824 Hillcreek Dr Augusta GA 30909-5628 |
| Mailing Address |
2824 Hill Creek Drive Augusta GA 30909 |
| Practice Telephone | 7068604567 |
| Practice Fax Number | 7068604489 |
| Mailing Telephone | 7068604567 |
| Mailing Fax Number | 7068604489 |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2007-11-20 |
| Authorized Official Name | AUDREY M. HENDERSON (PRESIDENT) |
| Authorized Official Telephone | 7068604567 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 029884 | GA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00383897A | 05 | |
| GA | MEDICARE GROUP # | GRP6154 | 01 |
| Street Address |
2824 HILLCREEK DR |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30909-5628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730747478 | Leanne Marie Row | Occupational Therapist | 2824 Hillcreek Dr, Augusta, GA 30909-5628 | 2019-05-29 |
| 1114412863 | Adam Lee Allen | Behavioral Analyst | 2824 Hillcreek Dr, Augusta, GA 30909 | 2018-06-26 |
| 1689198194 | Pediatric Autism Clinical & Evaluation Services LLC | Behavioral Analyst | 2824 Hillcreek Dr, Augusta, GA 30909-5628 | 2017-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513888 | Lauran Simpson | Behavior Technician | 1237 Augusta West Parkway, Augusta, GA 30909 | 2020-09-16 |
| 1487273884 | Still Perspectives Counseling LLC | Counselor | 1265 Inerstate Prwy, Suite B, Augusta, GA 30909 | 2020-04-15 |
| 1598397838 | Mjra Medical LLC | Psychologist | 3675 J Dewey Gray Cr Ste 300, Augusta, GA 30909 | 2020-02-05 |
| 1003452319 | Danny Robinson | Counselor | 2609 Commons Boulevard, Augusta, GA 30909 | 2019-11-21 |
| 1407498637 | Candice M Cruse | Social Worker | 2609 Commons Blvd, Augusta, GA 30909 | 2019-10-09 |
| 1902363385 | Mary D Jodon | Pharmacist | 3338 Wrightsboro Rd., Augusta, GA 30909 | 2019-02-21 |
| 1447790514 | Burn Critical Care Associates, LLC | Internal Medicine | 3614 J. Dewey Gray Circle, Bldg B., Augusta, GA 30909 | 2017-03-08 |
| 1124561766 | Sasha Latara Mccraw | Counselor | 7303 Palomino Court, Augusta, GA 30909 | 2016-11-30 |
| 1174974620 | Warren Umansky, Ph.d. | Psychologist | 302 Wheeler Executive Ctr, Augusta, GA 30909 | 2016-06-27 |
| 1811358955 | Theodora Mcleskey | Nurse Practitioner | 1215 George C. Wilson Drive, Augusta, GA 30909 | 2016-03-17 |
| Find all providers in zip 30909 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164056859 | Bimal R Shah Md PC | Specialist | 820 Saint Sebastian Way Ste 2a, Augusta, GA 30901-2636 | 2020-03-03 |
| 1407319676 | Tavories Ivey Sr. | Specialist | 4409 Silverton Rd, Augusta, GA 30909-9122 | 2019-04-12 |
| 1346708849 | Debra Imani Simms | Specialist | 519 Pleasant Home Rd Ste A1, Augusta, GA 30907-0545 | 2019-03-04 |
| 1821522715 | Amber Mccray | Specialist | 270 Bobby Jones Expy Ste 158, Augusta, GA 30907-3086 | 2017-04-18 |
| 1508231978 | Robert Jason Mitchell | Specialist | 950 15th St Rm 3c164, Augusta, GA 30901-2608 | 2015-12-10 |
| 1548654411 | Donecia Perrin-sullivan | Specialist | 524 Shartom Dr, Augusta, GA 30907-4751 | 2015-03-27 |
| 1396133153 | Veronica Ann Mccarthy | Specialist | 66 Hilltop Ln, Augusta, MI 49012-9502 | 2015-01-02 |
| 1225379738 | Dawn K Johnson | Specialist | 901 Bridge Creek Ln, Augusta, WI 54722-2603 | 2013-03-07 |
| 1962748210 | Helen Bryngelson | Specialist | 3581 Stevens Way, Augusta, GA 30907-9560 | 2012-12-13 |
| 1831469899 | Tanya Bernadette Quarterman | Specialist | 153 Hospital St Ste 13, Augusta, ME 04330 | 2012-01-09 |
| Find all providers in AUGUSTA | ||||
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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.