DR. PATRICK MICHAEL HENDERSON (NPI# 1477609345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477609345 |
| Entity Type | Individual |
| Full Name | DR. PATRICK MICHAEL HENDERSON |
| Credential | M.D. |
| Practice Address |
1 Wahoo Ave Groton CT 06349-2324 |
| Practice Telephone | 8606947555 |
| Practice Fax Number | 8606941303 |
| Mailing Telephone | 8606947555 |
| Mailing Fax Number | 8606941303 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-06-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 01064125A | IN | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740445121 | Patrick Ryan Henderson | Radiology | 410 Dickinson St, San Diego, CA 92103-6902 | 2008-07-24 |
| 1639185010 | Patrick Bouvier Henderson | Durable Medical Equipment & Medical Supplies | 500 E Arapaho Rd, Suite# 313, Richardson, TX 75081-2778 | 2006-07-31 |
| 1598720492 | Patrick Edward Henderson | Otolaryngology | 319 E Pioneer Ave, Montesano, WA 98563 | 2006-04-20 |
| 1427403963 | Patrick Glen Henderson | Psychiatry & Neurology | 6655 S Yale Ave, Tulsa, OK 74136-3326 | 2016-05-03 |
| 1386011518 | Patrick Henderson | Counselor | 3547 Habersham At Northlake, Building F, Tucker, GA 30084 | 2015-08-24 |
| 1902150527 | Patrick James Henderson | Internal Medicine | 6151 S Yale Ave Ste 100a, Tulsa, OK 74136 | 2012-11-05 |
| 1457651192 | Patrick J Henderson | Dentist | 4040 Lonesome Rd, Mandeville, LA 70448-7085 | 2010-10-28 |
| 1033304969 | Patrick Ronald Henderson I | Counselor | 1290 Chambers Rd, Aurora, CO 80011-7117 | 2007-09-13 |
| 1760507933 | Patrick Charles Henderson | Orthopaedic Surgery | 1605 E River Rd, Suite 101, Tucson, AZ 85718-5971 | 2007-03-20 |
| Street Address |
1 WAHOO AVE |
| City | GROTON |
| State | CT |
| Zip Code | 06349-2324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043207004 | Matthew Braden Burns Miller | Dentist | 1 Wahoo Ave, Groton, CT 06349 | 2005-10-04 |
| 1063027407 | Jimmy Nazih Suliman | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-09-12 |
| 1790395242 | Duc-nhan Nguyen Pham | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-08-08 |
| 1770112708 | Amanda Kathleen Dobyns | Occupational Therapist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-04-02 |
| 1831732825 | Cody Clark | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-10-22 |
| 1477103059 | Jordan Taylor Rucinski | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-09-16 |
| 1699335372 | Cynthia Daigneault | Counselor | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-06-16 |
| 1942868211 | Cameron Anson Martin | Military Health Care Provider | 1 Wahoo Ave, Groton, CT 06340 | 2019-06-03 |
| 1104386903 | Zena Sabath | General Practice | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-03-20 |
| 1538636527 | Winston Eugene Young | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2018-10-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434347 | Mvca | Optometrist | Navy Submarine Base New London, Bldg 484, Groton, CT 06349 | 2020-10-12 |
| 1376194274 | Christopher Lee Roy Smith | Military Health Care Provider | Uss San Juan (ssn 751), Groton, CT 06349 | 2019-09-23 |
| 1588127575 | Morgan Ross Jones | Student in an Organized Health Care Education/Training Program | Bx 159 Navsubase Nlon, Groton, CT 06349 | 2019-04-08 |
| 1689179640 | David Saunders | Military Health Care Provider | 159 Navsubase Nlon, Groton, CT 06349 | 2018-03-29 |
| 1013264423 | Dennis Buenaventura Custodio | Military Health Care Provider | 69 Trout Ave, Naval Undersea Medical Institute, Groton, CT 06349 | 2012-08-06 |
| 1609013549 | Nicolas David Mendoza | Military Health Care Provider | Uss Hawaii (ssn 776), Fpo, AE 06349 | 2009-01-14 |
| 1881843084 | Mark Francis Jarvis | Military Health Care Provider | Nssc Nlon, Bldg 76, Groton, CT 06349 | 2008-09-11 |
| 1780882738 | Michael Nutt | Military Health Care Provider | Bldg 517 Taugtog Ave, Navsubscol, Groton, CT 06349 | 2007-07-10 |
| 1497811343 | Keith Benjamin Hoekman | Nurse Practitioner | 1 Wahoo Dr, Groton, CT 06349 | 2006-12-28 |
| 1881604163 | Christina E Toufexis | Pediatrics | 1 Wahoo Drive, Groton, CT 06349 | 2006-08-09 |
| Find all providers in zip 06349 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235368242 | Hilde Hamar Westvik | Internal Medicine | 1 Forge Village Road, Ste C, Groton, MA 01450 | 2009-07-11 |
| 1689716813 | John P. Katzenberg | Internal Medicine | 292 Main St., Groton, MA 01450 | 2007-02-13 |
| 1902947658 | Nimesh K Patel | Internal Medicine | 404 Thames St, Suite 2, Groton, CT 06340-3959 | 2007-02-08 |
| 1295803534 | Montu Patel | Internal Medicine | 1 Forge Village Rd, Groton, MA 01450-2047 | 2006-12-04 |
| 1881683068 | Vandana Sahay | Internal Medicine | 497 Main St, Suite 4b, Groton, MA 01450-1298 | 2005-10-19 |
| 1326037508 | Alla R Sarkisyan | Internal Medicine | 497 Main Street, 4b, Groton, MA 01450 | 2005-10-19 |
| 1881686616 | Fred Yeo | Internal Medicine | Nhcne Groton, Groton, CT 06340 | 2005-08-18 |
| 1346246444 | Anandhi Baleswaren | Internal Medicine | 481 Gold Star Hwy, Suite 100, Groton, CT 06340-6702 | 2005-06-23 |
| 1871570218 | Alfred W. Heinser | Internal Medicine | 100 Boston Rd, Groton, MA 01450-1860 | 2005-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264659 | Urgent Care Center of Bloomfield Pllc | Internal Medicine | 699 Cottage Grove Rd, Bloomfield, CT 06002-3059 | 2020-10-28 |
| 1497353999 | Kaushar Desai | Internal Medicine | 23 Adam Dr, Newington, CT 06111-5143 | 2020-10-15 |
| 1255938940 | Shirley Kuan | Internal Medicine | 20 Taft St, Hamden, CT 06514-3422 | 2020-10-06 |
| 1306451869 | Falcon Medical LLC | Internal Medicine | 101 Washington Blvd Unit 1208, Stamford, CT 06902-7060 | 2020-09-11 |
| 1811509904 | Kristina Beauharnais | Internal Medicine | 18 Bedford Ave Apt 10, Norwalk, CT 06850-3849 | 2020-08-19 |
| 1720603087 | Ct Osteopathic, LLC | Internal Medicine | 41 Baldwin Ln, Glastonbury, CT 06033-3845 | 2020-06-12 |
| 1609495134 | West Hartford Primary Care, LLC | Internal Medicine | 9 Ellsworth Rd, West Hartford, CT 06107-2302 | 2020-04-14 |
| 1275178642 | Real Life Medical LLC | Internal Medicine | 1245 Farmington Ave # 226, West Hartford, CT 06107-2667 | 2019-11-09 |
| 1619525466 | Ilja Hulinsky Md PC | Internal Medicine | 4641 Main St Ste 3, Bridgeport, CT 06606-1827 | 2019-08-26 |
| 1023664125 | Emily Knowlton | Internal Medicine | 2000 Post Rd Ste 202, Fairfield, CT 06824-5730 | 2019-08-14 |
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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.