DR. JEFFREY HARRIS HENDERSON M.D. NPI 1235386848

NPI Information

  • NPI: 1235386848
  • Provider Name: DR. JEFFREY HARRIS HENDERSON, M.D.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 170 KIMEL PARK DR
    WINSTON SALEM, NC
    ZIP 27103
  • Phone: (704) 323-2000

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NPI Details

DR. Jeffrey Harris Henderson, M.D. is a family medicine in Winston Salem, NC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Jeffrey Harris Henderson, M.D. NPI is 1235386848. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

170 KIMEL PARK DR
WINSTON SALEM, NC
ZIP 27103-946
Phone: (704) 323-2000

The NPI 1235386848 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/26/2008 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QS0010XFamily MedicineSports Medicine2011-00070NORTH CAROLINANo
2207Q00000XFamily Medicine2011-00070NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11497704217MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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