MR. DEREK ALLEN HENDERSON (NPI# 1447530498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447530498 |
| Entity Type | Individual |
| Full Name | MR. DEREK ALLEN HENDERSON |
| Credential | PA |
| Practice Address |
1045 E Front St Buchanan MI 49107-8474 |
| Mailing Address |
Po Box 437 Buchanan MI 49107-0437 |
| Practice Telephone | 2696955540 |
| Practice Fax Number | 2696950412 |
| Mailing Telephone | 2696950262 |
| Mailing Fax Number | 2696952590 |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2016-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601006108 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255835302 | Derek C. Henderson | Psychologist | 8270 Willow Oaks Corporate Dr Fl 3, Fairfax, VA 22031-4511 | 2018-03-22 |
| 1871038109 | Derek Henderson | Physician Assistant | 3726 Broadway Ste 201, Everett, WA 98201-3788 | 2016-12-22 |
| Street Address |
1045 E FRONT ST |
| City | BUCHANAN |
| State | MI |
| Zip Code | 49107-8474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538115233 | Cynthia Papendick Aprn Bc Inc | Registered Nurse | 1045 E Front St, Suite B2, Buchanan, MI 49107-8474 | 2006-05-25 |
| 1184176786 | Olivia Hemlock | Nurse Practitioner | 1045 E Front St, Buchanan, MI 49107-8474 | 2016-10-29 |
| 1003368713 | Southwest Vision Center Inc. | Optometrist | 1045 E Front St, Suite B4, Buchanan, MI 49107-8474 | 2016-10-28 |
| 1568911980 | Lakeland Medical Practices | Family Medicine | 1045 E Front St, Suite A, Buchanan, MI 49107-8474 | 2016-09-27 |
| 1639520851 | Lakeland Medical Practice | Family Medicine | 1045 E Front St, Suite A, Buchanan, MI 49107-8474 | 2016-06-29 |
| 1457743486 | Audrey Lynn Carrier | Family Medicine | 1045 E Front St, Buchanan, MI 49107 | 2015-02-27 |
| 1558766188 | Julia Kostyuk | Nurse Practitioner | 1045 E Front St, Buchanan, MI 49107-8474 | 2014-10-24 |
| 1790932168 | Susan Jayne Smith | Physician Assistant | 1045 E Front St, Buchanan, MI 49107-8474 | 2008-08-27 |
| 1275687147 | Roy B Parke D.o. | Family Medicine | 1045 E Front St, Buchanan, MI 49107-8474 | 2007-01-22 |
| 1699885061 | Arlene Mae Saliba El Habre | Nurse Practitioner | 1045 E Front St, Buchanan, MI 49107-8474 | 2006-08-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447453188 | Ronald C Carr | Dentist | 802 East Front St, Ste 5, Buchanan, MI 49107 | 2007-06-08 |
| 1669696464 | Barbara A Starke | Registered Nurse | 804 E Front Street, Buchanan, MI 49107 | 2007-04-12 |
| 1558338368 | Respiratory Home Care & Convalescent Supply Inc | Durable Medical Equipment & Medical Supplies | 320 N Redbud Trail, Buchanan, MI 49107 | 2006-03-01 |
| 1255827382 | Kari Mitchell-coplen | Physical Therapy Assistant | 500 E 3rd St, Buchanan, MI 49107 | 2018-07-01 |
| 1790294064 | Red Bud Health Services LLC | Physical Therapist | 500 E 3rd St, Buchanan, MI 49107 | 2017-09-29 |
| 1740801653 | Sharon M Bradley | Nursing Care | 324 N Detroit St, Buchanan, MI 49107-1204 | 2020-05-01 |
| 1235526260 | Into His Rest Ministries | Social Worker | 102 Elizabeth St, Buchanan, MI 49107-1327 | 2015-04-16 |
| 1851443956 | Drs Steven and Brenda Smoke Od PC | Optometrist | 400 E Front St, Suite A, Buchanan, MI 49107-1403 | 2007-01-17 |
| 1306998919 | Brenda Dani Smoke | Optometrist | 400 E Front St Ste A, Buchanan, MI 49107-1403 | 2007-01-17 |
| 1275984908 | Adam Urbanski | Optometrist | 400 E Front St, Ste A, Buchanan, MI 49107-1403 | 2016-06-23 |
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| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861483877 | Timothy J Pardoe | Physician Assistant | 30 Buchanan Byp, Buchanan, GA 30113-4924 | 2005-10-31 |
| 1790932168 | Susan Jayne Smith | Physician Assistant | 1045 E Front St, Buchanan, MI 49107-8474 | 2008-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164022331 | Anna Lynn Shrift | Physician Assistant | 849 Black Hill Ln, Traverse City, MI 49696-8674 | 2020-10-27 |
| 1972102556 | Aaron Buckley | Physician Assistant | 567 Saint Louis St, Ferndale, MI 48220-2436 | 2020-10-23 |
| 1013516194 | Rebecca Mary Cronin | Physician Assistant | 4311 Kingsbrook Dr, Kalamazoo, MI 49006-3909 | 2020-10-20 |
| 1801495023 | Keriah Khairi Abd | Physician Assistant | 42836 Bloomingdale Dr, Sterling Heights, MI 48314-2843 | 2020-10-19 |
| 1154929016 | Angela Varghese | Physician Assistant | 461 Tanner Dr, Troy, MI 48085-4714 | 2020-10-13 |
| 1861090730 | Maloree Blayke Perkins | Physician Assistant | 20717 Coventry St, Clinton Twp, MI 48035-1603 | 2020-10-13 |
| 1801494000 | Sarah Puchala Lucero | Physician Assistant | 25614 Wilson Dr, Dearborn Heights, MI 48127-3427 | 2020-10-12 |
| 1871191007 | Julia Marie Tucker | Physician Assistant | 12250 E Ridge Dr, Bruce Twp, MI 48065-2011 | 2020-10-10 |
| 1164020301 | Sara Whitneyann Vandeman | Physician Assistant | 7901 S 12th St Ste 101, Portage, MI 49024-3831 | 2020-10-10 |
| 1831796267 | Jowharh Zindani | Physician Assistant | 12020 Mitchell St, Hamtramck, MI 48212-2722 | 2020-10-08 |
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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.