JESSICA LYNN HENDERSON (NPI# 1174745665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174745665 |
| Entity Type | Individual |
| Full Name | JESSICA LYNN HENDERSON |
| Credential | D.O. |
| Practice Address |
4420 Lake Boone Trail Raleigh NC 27607-2360 |
| Mailing Address |
3100 Spring Forest Rd Suite 130 Raleigh NC 27616-2880 |
| Practice Telephone | 9197843100 |
| Mailing Telephone | 9198739533 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2014-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | 2010-00808 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1174745665 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790154524 | Jessica Henderson | Massage Therapist | 6010 Balcones Dr Ste 260, Austin, TX 78731-4294 | 2015-09-22 |
| 1548607005 | Jessica L Henderson | Social Worker | 3725 Lilly Rd N, Jacksonville, FL 32207-2343 | 2013-05-23 |
| 1659612059 | Jessica Henderson | Behavioral Analyst | 1640 Ribaut Rd Apt 101, Port Royal, SC 29935-1737 | 2013-03-09 |
| 1194905265 | Jessica Janel Henderson | Speech-Language Pathologist | 10876 Eclipse Lily Way, Orlando, FL 32832-5882 | 2007-11-06 |
| 1659988020 | Jessica Henderson | Physical Therapist | 134 Hall St Unit 1, Concord, NH 03301-3470 | 2020-09-29 |
| 1083227060 | Jessica Lynn Henderson | Nurse Practitioner | 200 Glenn St Ste 302, Cumberland, MD 21502-2583 | 2020-08-28 |
| 1588204077 | Jessica Andrea Henderson | Nurse Practitioner | 113 Pleasant Valley Dr Ste 210, Boerne, TX 78006-5683 | 2020-01-13 |
| 1336705425 | Jessica Henderson | Behavioral Analyst | 12432 Bellflower Blvd, Downey, CA 90242-2806 | 2019-05-14 |
| 1497214787 | Jessica Henderson | Case Manager/Care Coordinator | 2632 Sw Port St Lucie Blvd, Port St Lucie, FL 34953-2845 | 2019-03-16 |
| 1982195681 | Jessica Henderson | Behavioral Analyst | 2110 Los Feliz St Unit 2072, Las Vegas, NV 89156-8026 | 2018-05-29 |
| Street Address |
4420 LAKE BOONE TRAIL |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607-2360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013994714 | Lisa F Dejarnette | Internal Medicine | 4420 Lake Boone Trail, Raleigh, NC 27607 | 2005-12-23 |
| 1356976161 | Chelsea Kennedy Harris | Registered Nurse | 4420 Lake Boone Trail, Raleigh, NC 27607-7505 | 2020-03-12 |
| 1902159601 | Nathalie Kim | Nurse Anesthetist, Certified Registered | 4420 Lake Boone Trail, Raleigh, NC 27607-6599 | 2012-10-18 |
| 1609125095 | Elizabeth Beach Mcneely | Pharmacist | 4420 Lake Boone Trail, Rex Hospital Pharmacy Department, Raleigh, NC 27607 | 2012-08-31 |
| 1760775936 | Mary Brigid Farrell | Nurse Anesthetist, Certified Registered | 4420 Lake Boone Trail, Raleigh, NC 27616-2880 | 2011-05-22 |
| 1992011316 | Tiffany Kinton Carter | Registered Nurse | 4420 Lake Boone Trail, Raleigh, NC 27607-7505 | 2010-08-23 |
| 1376858910 | Jason Kaplan | Registered Nurse | 4420 Lake Boone Trail, Raleigh, NC 27607-7505 | 2010-08-06 |
| 1194058024 | Kimberly Townes Soden | Registered Nurse | 4420 Lake Boone Trail, Raleigh, NC 27607 | 2009-09-10 |
| 1386828754 | Nevin Mahendra Shrimanker | Anesthesiology | 4420 Lake Boone Trail, Critical Health Systems Office - Rex Hospital, Raleigh, NC 27607 | 2007-12-20 |
| 1083836001 | Matthew Atkins | Anesthesiology | 4420 Lake Boone Trail, Rex Healthcare, Raleigh, NC 27607 | 2007-05-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
| Find all providers in zip 27607 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417472994 | Blue Ridge Sedation Associates LLC | Anesthesiology | 2417 Atrium Dr Ste 101, Raleigh, NC 27607-6673 | 2017-08-07 |
| 1659548899 | Allyson K Bryant | Anesthesiology | 2605 Blue Ridge Rd Ste 330, Raleigh, NC 27607-6475 | 2008-05-15 |
| 1417131376 | Timothy Lynn Gruebel | Anesthesiology | 1906 Aurora Dr, Raleigh, NC 27615-5501 | 2007-12-27 |
| 1043369820 | Peter Albert Modrow | Anesthesiology | 312 Meeting House Cir, Raleigh, NC 27615-3131 | 2007-01-09 |
| 1740213354 | Reed Matthew Vanmatre | Anesthesiology | 3000 New Bern Avenue, Raleigh, NC 27610-1231 | 2006-07-08 |
| 1053364141 | Kevin E Vorenkamp | Anesthesiology | 3404 Wake Forest Rd Ste 300, Raleigh, NC 27609 | 2006-05-18 |
| 1487604971 | Mohammad Maroof | Anesthesiology | 4041 Ed Dr, Suite 104 & 108, Raleigh, NC 27612-8004 | 2006-05-12 |
| 1417940990 | Paul P. Carnes | Anesthesiology | 1520 Sunday Dr, Raleigh, NC 27607-5253 | 2005-08-30 |
| 1710512314 | Midtown Raleigh Anesthesia | Anesthesiology | 2600 Atlantic Ave Ste 100, Raleigh, NC 27604-1502 | 2020-03-04 |
| 1427508316 | North American Partners In Anesthesia North Carolina Pllc | Anesthesiology | 3031 New Bern Ave, Suite 100, Raleigh, NC 27610-2988 | 2016-10-04 |
| Find all providers in RALEIGH | ||||
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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.