AUDREY M HENDERSON (NPI# 1639161102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639161102 |
| Entity Type | Individual |
| Full Name | AUDREY M HENDERSON |
| Credential | M.D. |
| Practice Address |
1109 Medical Center Dr Suite 3 Augusta GA 30909-6644 |
| Practice Telephone | 7068604567 |
| Practice Fax Number | 7068604489 |
| Mailing Telephone | 7068604567 |
| Mailing Fax Number | 7068604489 |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2016-11-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | GA029884 | GA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 029884 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00383897A | 05 |
| Street Address |
1109 MEDICAL CENTER DR SUITE 3 |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30909-6644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174521132 | Michael Lynn Whitlow | Specialist | 1109 Medical Center Dr, Building #5, Augusta, GA 30909-6633 | 2005-07-13 |
| 1164692786 | Csra Internal Medicine Associates, PC | Legal Medicine | 1109 Medical Center Dr, Suite 1a, Augusta, GA 30909-6633 | 2008-03-11 |
| 1245422112 | Coastal Air, Inc | Ambulance | 1109 Medical Center Dr, Bldg 4, Augusta, GA 30909-6633 | 2007-08-15 |
| 1942408216 | Stephens Clinic LLC | Anesthesiology | 1109 Medical Center Dr, Suite 8a, Augusta, GA 30909-6633 | 2007-07-06 |
| 1588873400 | Russell S Stephens | Anesthesiology | 1109 Medical Center Dr, 8a, Augusta, GA 30909-6633 | 2007-05-21 |
| 1437299211 | West Augusta Internal Medicine Associates | Internal Medicine | 1109 Medical Center Dr, Building 3, Augusta, GA 30909-6633 | 2007-02-08 |
| 1265503841 | Leslie N Kahn | Legal Medicine | 1109 Medical Center Dr, Suite 1a, Augusta, GA 30909-6633 | 2006-11-13 |
| 1114037629 | Michael J. Cohen, M.d., P.C. | Specialist | 1109 Medical Center Dr, Suite 8b, Augusta, GA 30909-6633 | 2006-08-30 |
| 1396786760 | Augusta Renal Physicians, P.C. | Internal Medicine | 1109 Medical Center Dr, Building #5, Augusta, GA 30909-6633 | 2006-06-09 |
| 1730168428 | Kelly A Mcsweeney | Pathology | 1109 Medical Center Dr, Suite 1a, Augusta, GA 30909-6633 | 2006-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513888 | Lauran Simpson | Behavior Technician | 1237 Augusta West Parkway, Augusta, GA 30909 | 2020-09-16 |
| 1487273884 | Still Perspectives Counseling LLC | Counselor | 1265 Inerstate Prwy, Suite B, Augusta, GA 30909 | 2020-04-15 |
| 1598397838 | Mjra Medical LLC | Psychologist | 3675 J Dewey Gray Cr Ste 300, Augusta, GA 30909 | 2020-02-05 |
| 1003452319 | Danny Robinson | Counselor | 2609 Commons Boulevard, Augusta, GA 30909 | 2019-11-21 |
| 1407498637 | Candice M Cruse | Social Worker | 2609 Commons Blvd, Augusta, GA 30909 | 2019-10-09 |
| 1902363385 | Mary D Jodon | Pharmacist | 3338 Wrightsboro Rd., Augusta, GA 30909 | 2019-02-21 |
| 1447790514 | Burn Critical Care Associates, LLC | Internal Medicine | 3614 J. Dewey Gray Circle, Bldg B., Augusta, GA 30909 | 2017-03-08 |
| 1124561766 | Sasha Latara Mccraw | Counselor | 7303 Palomino Court, Augusta, GA 30909 | 2016-11-30 |
| 1174974620 | Warren Umansky, Ph.d. | Psychologist | 302 Wheeler Executive Ctr, Augusta, GA 30909 | 2016-06-27 |
| 1811358955 | Theodora Mcleskey | Nurse Practitioner | 1215 George C. Wilson Drive, Augusta, GA 30909 | 2016-03-17 |
| Find all providers in zip 30909 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649889874 | Kateri Jeffery | Family Medicine | 12 Shuman Ave Ste 3, Augusta, ME 04330-6020 | 2020-07-23 |
| 1548885783 | Candace Clinton | Family Medicine | 1120 15th St # Hb4000, Augusta, GA 30912-0004 | 2020-06-13 |
| 1750906012 | Nand Vinod Patel | Family Medicine | 3039 Washington Rd, Augusta, GA 30907-3829 | 2020-06-12 |
| 1114542396 | Lauren C Robinson | Family Medicine | 1120 15th St # Hb3000e, Augusta, GA 30912-0004 | 2020-06-12 |
| 1831714211 | Soren Knudsen Estvold | Family Medicine | 1120 15th St # Hb-4000, Augusta, GA 30912-0004 | 2020-06-11 |
| 1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
| 1942793005 | Rebecca Tate Jones | Family Medicine | 1120 15th St Augusta Ga 30912, Augusta, GA 30912-0001 | 2018-06-12 |
| 1811480411 | Sonya Janice Chelliah | Family Medicine | 1120 15th St # Hb3020, Augusta, GA 30912-0004 | 2018-06-08 |
| 1447741269 | Akua E Asiamah | Family Medicine | 1120 15th St Augusta University, Augusta, GA 30912-0001 | 2018-05-29 |
| 1457766800 | Susan B. Allen Memorial Hospital | Family Medicine | 401 W 7th Ave, Augusta, KS 67010-1309 | 2014-06-24 |
| Find all providers in AUGUSTA | ||||
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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.