DR. HENDERSON MICHAEL LANE (NPI# 1821181157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821181157 |
| Entity Type | Individual |
| Full Name | DR. HENDERSON MICHAEL LANE |
| Credential | MD |
| Practice Address |
4500 Stuart St Moncrief Army Community Hospital/credentials Columbia SC 29207-5700 |
| Mailing Address |
4500 Stuart St Moncrief Army Hospital, Attn: Mcxl-pq (credentials) Columbia SC 29207-5700 |
| Practice Telephone | 8037512618 |
| Practice Fax Number | 8037512689 |
| Mailing Telephone | 8037512618 |
| Mailing Fax Number | 8037512689 |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 14222 | SC | Allopathic & Osteopathic Physicians |
| Street Address |
4500 STUART ST MONCRIEF ARMY COMMUNITY HOSPITAL/CREDENTIALS |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29207-5700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912505231 | Christopher Michael Enke | Occupational Therapist | 4500 Stuart St, Columbia, SC 29207-5700 | 2020-10-09 |
| 1366071144 | Kaitlin Chrastek | Specialist/Technologist | 4500 Stuart St, Columbia, SC 29207-5700 | 2020-04-03 |
| 1316582455 | Melissa Angela Metivier | Physical Therapist | 4500 Stuart St, Columbia, SC 29207-5700 | 2019-11-13 |
| 1952954695 | Jeriann Sandrik | Optometrist | 4500 Stuart St, Columbia, SC 29207 | 2019-07-22 |
| 1669946455 | Tonya Yvette Parks | Counselor | 4500 Stuart St, Columbia, SC 29207-5700 | 2019-01-15 |
| 1538653795 | Jennifer L Willard | Licensed Practical Nurse | 4500 Stuart St, Columbia, SC 29207-5700 | 2018-06-20 |
| 1114469475 | Carrie Elizabeth Green | Physical Therapist | 4500 Stuart St, Columbia, SC 29207-5700 | 2016-11-17 |
| 1841640489 | Daniel Greathouse | Optometrist | 4500 Stuart St, 3rd Floor Clinic Wing, Columbia, SC 29207-5700 | 2016-06-14 |
| 1356796205 | Rajesh Devkota | Nurse Practitioner | 4500 Stuart St, Columbia, SC 29207-5700 | 2016-04-28 |
| 1114385770 | Garry Dredge | Physical Therapist | 4500 Stuart St, Columbia, SC 29207-5700 | 2016-02-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265043756 | Steven Mariani Rodriguez | Dentist | 5330 Moseby Street, Columbia, SC 29207 | 2020-08-10 |
| 1568082493 | Nichole Eckrich | Dentist | 5330 Moseby St., Columbia, SC 29207 | 2020-04-21 |
| 1730733007 | Forrest Wane Fullenkamp | Student in an Organized Health Care Education/Training Program | 5330 Moseby St, Columbia, SC 29207 | 2019-07-25 |
| 1306401625 | Kayla Anne Wolcott | Pharmacist | Moncrief Army Hospital Outpatient Pharmacy 1 Ft Jackson, Columbia, SC 29207 | 2019-05-02 |
| 1588145098 | Renetta Denise Green | Counselor | Fort Jackson/acs 9810 Lee St, Columbia, SC 29207 | 2018-08-23 |
| 1154814028 | Amanda Zelnick | Dentist | Bldg 5330 Moseby St, Ft Jackson, NC 29207 | 2018-06-14 |
| 1790231777 | Brittaney Elizabeth Anne Lewelling | Specialist/Technologist | 5975 Chesnut Road, Columbia, SC 29207 | 2016-08-30 |
| 1376749838 | Moncrief Army Community Hospital | Clinic/Center | 5330 Mosby Street, Fort Jackson, SC 29207 | 2007-06-22 |
| 1902002462 | Moncrief Army Community Hospital | Clinic/Center | 1890 Washington Road, Fort Jackson, SC 29207 | 2007-06-22 |
| 1730279860 | Donna L Briquet | Pharmacist | 4500 Marion Street, Columbia, SC 29207 | 2006-10-12 |
| Find all providers in zip 29207 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1255945754 | Escobedo Advanced Healthcare Solutions LLC | General Practice | 121 Sparkleberry Crossing Rd Ste 200, Columbia, SC 29229-8639 | 2020-09-02 |
| 1295208403 | Sme Kentucky Psc | General Practice | 5728 Pergola Dr Apt 207, Columbia, MO 65201-2897 | 2019-01-10 |
| 1093218224 | Andrew Jason Doppelt | General Practice | 200 E Southampton Dr Ste 104, Columbia, MO 65203-3032 | 2018-03-14 |
| 1235648551 | Robert Calaluce | General Practice | 140 Walter Williams Hall, Columbia, MO 65211-1200 | 2017-09-29 |
| 1013301738 | Harold Woodliff Sanford Jr. | General Practice | 1829 Senate St Apt 9c, Columbia, SC 29201-3837 | 2015-03-19 |
| 1710383435 | Epoch - Central Missouri Limited Liability Company | General Practice | 2900 Trimble Rd., Columbia, MO 65201-6465 | 2014-11-06 |
| 1396093068 | Inder S Gujral | General Practice | 8795 Endless Ocean Way, Columbia, MD 21045-5938 | 2012-08-28 |
| 1407104482 | Gary Mosher Jones | General Practice | 2004 Riding Ridge Rd, Columbia, SC 29223-6713 | 2012-08-22 |
| 1972861854 | William Frederick Mcfadden | General Practice | 3121 Chinaberry Dr, Columbia, SC 29204-3664 | 2012-04-27 |
| 1215255617 | Barr Enterprises,llc | General Practice | 112 Norse Dr, Columbia, SC 29229-3304 | 2010-05-10 |
| Find all providers in COLUMBIA | ||||
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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.