JOHN M HENDERSON DO PC (NPI# 1699947176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699947176 |
| Entity Type | Organization |
| Organization Name | JOHN M HENDERSON DO PC |
| Practice Address |
2300 Manchester Expy Bldg G202 Columbus GA 31904-6802 |
| Practice Telephone | 7063235717 |
| Practice Fax Number | 7063236010 |
| Mailing Telephone | 7063235717 |
| Mailing Fax Number | 7063236010 |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-03-25 |
| Authorized Official Name | DR. JOHN MCKENZIE HENDERSON SR. (PRESIDENT) |
| Authorized Official Telephone | 7063235717 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
025765 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | LICENSE | 025765 | 01 |
| GA | MEDICARE GROUP | GRP6429 | 01 |
| GA | DEA | AH2421751 | 01 |
| GA | MEDICARE PROVIDER | 08BBQVH | 01 |
| GA | UPIN | D45629 | 01 |
| Street Address |
2300 MANCHESTER EXPY BLDG G202 |
| City | COLUMBUS |
| State | GA |
| Zip Code | 31904-6802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811994403 | Sebastian O Hubbuch | Internal Medicine | 2300 Manchester Expy, Ste 1003, Columbus, GA 31904-6877 | 2005-06-28 |
| 1730615790 | Petra S Glover | Nurse Practitioner | 2300 Manchester Expy, Ste 1003, Columbus, GA 31904-6802 | 2017-05-11 |
| 1063956795 | Rebekah Begly | Nurse Practitioner | 2300 Manchester Expy, Butler Pavilion, Suite 1007, Columbus, GA 31904-6802 | 2016-12-14 |
| 1528517802 | Tracy B Stokes | Nurse Practitioner | 2300 Manchester Expy, Ste C001, Columbus, GA 31904-6802 | 2016-09-27 |
| 1073066254 | Chelsea Lawrence | Nurse Practitioner | 2300 Manchester Expy, Suite 2001, Butler Pavilion, Columbus, GA 31904-6802 | 2016-07-25 |
| 1609229863 | Dixie Peterson | Nurse Practitioner | 2300 Manchester Expy, Suite 2001, Columbus, GA 31904-6802 | 2016-07-22 |
| 1720430440 | Alexander Chavez | Nurse Practitioner | 2300 Manchester Expy, Ste 1009, Columbus, GA 31904-6802 | 2016-07-06 |
| 1437506318 | Michael Lemke | Nurse Practitioner | 2300 Manchester Expy, Building A, Suite 6, Columbus, GA 31904-6802 | 2016-05-19 |
| 1568822286 | Summer Carol Still | Nurse Practitioner | 2300 Manchester Expy, Suite 2001, Columbus, GA 31904-6802 | 2016-02-24 |
| 1861857294 | St. Francis Physician Practices LLC | Physical Medicine & Rehabilitation | 2300 Manchester Expy, Ste A005, Columbus, GA 31904-6802 | 2015-12-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821641457 | At Home Palliative Care, LLC | Nursing Care | 114 Enterprise Ct, Suite B, Columbus, GA 31904 | 2019-07-23 |
| 1285191049 | Shandra Ladell Grimes | Nurse Practitioner | 2300 Manchester Expwy St Francis Hospital, Suite C-001, Columbus, GA 31904 | 2019-02-27 |
| 1881161529 | Lesley Kathleen Simmons | Massage Therapist | 5402 15th Ave, Columbus, GA 31904 | 2018-10-31 |
| 1184190662 | Alphonsa Joseph | Nurse Practitioner | 2430 Brookstone Centre Parkway, Columbus, Georgia 31904, Columbus, GA 31904 | 2018-10-22 |
| 1568942704 | William Pearce Massey | Social Worker | 8851-1 Moore Road, Columbus, GA 31904 | 2018-08-17 |
| 1033696372 | Marlise V. Gray | Counselor | 2013 Devonshire Dr. Suite 115, Columbus, GA 31904 | 2018-07-19 |
| 1710418173 | Amanda Barnette Pruett | Behavioral Analyst | 200 Brookstone Centre Pkwy Bldg 200, Columbus, GA 31904 | 2017-03-27 |
| 1750833232 | Carrie Leigh Whitehead | Nurse Practitioner | 6228 Bradley Park Dr. Suite A, Columbus, GA 31904 | 2016-10-31 |
| 1609323369 | Shomika Lasha Battle | Registered Nurse | 2101 North Avenue, Columbus, GA 31904 | 2016-09-09 |
| 1952759219 | Peaceful River Home Care Agency | In Home Supportive Care | 738 Rudgate Road, Columbus, GA 31904 | 2016-05-27 |
| Find all providers in zip 31904 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| 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 Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477597979 | John M. Henderson Sr. | Family Medicine | 1900 10th Ave Suite 320, Columbus, GA 31901 | 2006-06-15 |
| 1457346058 | Richard Martin | Family Medicine | 50 Mcnaughten Rd Ste 202, Columbus, OH 43213-2193 | 2005-09-20 |
| 1962964833 | Hughston Medical Group, PC | Family Medicine | 1900 10th Ave Ste 211, Columbus, GA 31901-3604 | 2019-04-01 |
| 1184078644 | Margaret Doe | Family Medicine | 543 Taylor Ave Fl 2, Columbus, OH 43203-1278 | 2016-04-20 |
| 1164717260 | Benjamin Jacob Burkam | Family Medicine | 697 Thomas Ln, Columbus, OH 43214 | 2011-06-16 |
| 1619276656 | Ohiohealth Corporation | Family Medicine | 3705 Olentangy River Rd Ste 260, Columbus, OH 43214-3467 | 2011-03-16 |
| 1093950560 | Grant/riverside Medical Care Foundation, Inc | Family Medicine | 3705 Olentangy River Rd, Ste 260, Columbus, OH 43214-3467 | 2008-12-11 |
| 1982809273 | John W Diehl | Family Medicine | 3773 Olentangy River Rd, Columbus, OH 43214-3425 | 2007-06-18 |
| 1558446765 | Kiersten W Arthur | Family Medicine | 700 Childrens Dr, Columbus, OH 43205-2664 | 2006-10-26 |
| 1457330078 | Joel Lewis Shaw | Family Medicine | 3705 Olentangy River Rd, Ste 260, Columbus, OH 43214-3467 | 2006-01-12 |
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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.