MR. CORY RYAN HENDERSON (NPI# 1174883292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174883292 |
| Entity Type | Individual |
| Full Name | MR. CORY RYAN HENDERSON |
| Credential | PA-C |
| Practice Address |
201 Independence Columbus MS 39710-5300 |
| Mailing Address |
201 Independence Dr Columbus Afb MS 39701 |
| Practice Telephone | 6624341126 |
| Mailing Telephone | 6624341126 |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2012-10-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326200486 | Cory E. Henderson | Chiropractor | 3662 E Sunset Rd, Suite #110, Las Vegas, NV 89120-7240 | 2008-06-30 |
| 1932626835 | Cory Henderson | Community Health Worker | 4989 N 3rd St, Laramie, WY 82072-9548 | 2017-08-23 |
| 1124382650 | Cory Shamar Henderson | Internal Medicine | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2012-06-29 |
| Street Address |
201 INDEPENDENCE |
| City | COLUMBUS |
| State | MS |
| Zip Code | 39710-5300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811993843 | Cynthia Barrett | Social Worker | 201 Independence, Columbus, MS 39710-5300 | 2005-06-23 |
| 1346804531 | Caley Kropp | Student in an Organized Health Care Education/Training Program | 201 Independence, Columbus, MS 39710-5300 | 2019-04-24 |
| 1932696713 | James Tyler Bates | Family Medicine | 201 Independence, Columbus, MS 39710 | 2018-04-17 |
| 1497261051 | Gregory Correale | Pharmacist | 201 Independence, Columbus, MS 39710-5300 | 2017-12-19 |
| 1235580465 | Clare Weitz | Pharmacist | 201 Independence, Suite 2255, Columbus, MS 39710-5300 | 2016-06-29 |
| 1144679994 | Faga Samdumu | Pharmacist | 201 Independence, Columbus, MS 39710-5300 | 2016-06-11 |
| 1972964591 | Lauren Beers | Physical Therapist | 201 Independence, Columbus, MS 39710 | 2016-03-09 |
| 1780081026 | Anna Friscia | Registered Nurse | 201 Independence, Columbus, MS 39710-5300 | 2014-12-02 |
| 1992117378 | Jennifer Bryant Williams | Social Worker | 201 Independence, Columbus, MS 39710 | 2014-05-20 |
| 1891105466 | Robin Thompson | Registered Nurse | 201 Independence, Columbus, MS 39710-5300 | 2014-05-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558653063 | Steven Thomas Fosmire | Preventive Medicine | 14th Medical Group, 201 Independence Dr., Ste 2255, Columbus Afb, MS 39710 | 2011-05-03 |
| 1457311573 | Benjamin Jordan Franklin | Optometrist | 14 Medical Group, 201 Independence Dr Ste 235, Columbus Afb, MS 39710 | 2006-03-24 |
| 1396713194 | Kirk Tracy Moss | Family Medicine | 14th Mdg, 201 Independence Dr, Columbus Afb, MS 39710 | 2006-03-09 |
| 1659367266 | Paul H Nelson | Family Medicine | 201 Independence Dr, 14th Medical Group Ste 235, Columbus Afb, MS 39710 | 2005-09-20 |
| 1467447201 | James Henry Heriot | Internal Medicine | 201 Independence Drive, 14th Medical Group/sgoq, Columbus Afb, MS 39710 | 2005-09-19 |
| 1699372938 | Stacie Lynn Penkova | Pharmacist | 14th Medical Group, 201 Independence Drive, Columbus Afb, MS 39710 | 2020-10-08 |
| 1558740019 | William Jennings Amador | Family Medicine | 201 Independence Drive, 14th Medical Group, Columbus Afb, MS 39710 | 2015-05-29 |
| 1225457534 | Kenneth Richard Taylor | Preventive Medicine | 14th Medical Group, 201 Independence Drive, Columbus Afb, MS 39710 | 2014-04-15 |
| 1437414281 | Valerie Ayana Brennan | Social Worker | 14th Medical Group, 201 Independence Drive, Columbus, MS 39710 | 2012-07-09 |
| 1477845261 | Richard Joseph Levitre | Psychiatry & Neurology | 14th Medical Group 201 Independence Drive, Columbus, MS 39710 | 2011-05-11 |
| Find all providers in zip 39710 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972960359 | Autumn Combs | Physician Assistant | 437 N Gould Rd Apt F, Columbus, OH 43209-1139 | 2016-01-15 |
| 1740665926 | Julianne Gonzalez | Physician Assistant | 350 Manchester Expy, Columbus, GA 31904-6435 | 2015-07-29 |
| 1629461165 | Michael Bryant | Physician Assistant | 911 Rudgate Rd, Columbus, GA 31904-2948 | 2015-03-09 |
| 1174880447 | Ricky Lee Martin Jr. | Physician Assistant | 2326 18th St Ste 210, Columbus, IN 47201-5362 | 2012-04-11 |
| 1710068374 | April K Howell | Physician Assistant | 2008 Wynnton Rd, Columbus, GA 31906-2407 | 2006-10-18 |
| 1124035399 | Diane L. Mitchell | Physician Assistant | 1130 Talbotton Rd, Columbus, GA 31904-8749 | 2006-08-01 |
| 1194752790 | Karen L Goodale | Physician Assistant | 2881 Nc Hwy 108 E, Columbus, NC 28722-7721 | 2006-06-27 |
| 1164469979 | Mark H Epps | Physician Assistant | 2000 10th Ave Ste 270, Columbus, GA 31901-3706 | 2006-06-01 |
| 1164484689 | Jim Lawrence Mcevers | Physician Assistant | 109 Shult Dr, Suite 101, Columbus, TX 78934-3015 | 2006-04-03 |
| 1972586287 | Susan A Farwell | Physician Assistant | 45 E Mills St, Columbus, NC 28722 | 2005-11-22 |
| Find all providers in COLUMBUS | ||||
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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.