DR. CHANCE JACK HENDERSON (NPI# 1851503544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1851503544 |
Entity Type | Individual |
Full Name | DR. CHANCE JACK HENDERSON |
Credential | M.D. |
Practice Address |
4102 Pinion Dr Usaf Academy CO 80840-2502 |
Practice Telephone | 7193335042 |
Practice Fax Number | 7193335670 |
Mailing Telephone | 7193335042 |
Mailing Fax Number | 7193335670 |
Enumeration Date | 2007-05-04 |
Last Update Date | 2018-03-13 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
036.142192 | IL | Allopathic & Osteopathic Physicians |
Y | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
DR.0051822 | CO | Allopathic & Osteopathic Physicians |
N | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
N8660 | TX | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 1851503544 | 05 |
Street Address |
4102 PINION DR |
City | USAF ACADEMY |
State | CO |
Zip Code | 80840-2502 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336776467 | Rebecca Briones | Student in an Organized Health Care Education/Training Program | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2020-03-26 |
1588222129 | Christopher J Drager | Physical Therapist | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2019-05-29 |
1346706454 | Hannah M Szilagy | Physical Therapist | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2019-02-13 |
1831671262 | Alexander Ortiz | Physician Assistant | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2018-09-01 |
1336629096 | Kim D Tran | Family Medicine | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2018-08-21 |
1235624065 | Lauren Yurish-crittenden | Psychologist | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2018-06-25 |
1477055572 | Keeley Katrein | Physician Assistant | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2018-03-05 |
1588162176 | Justin James Fleming | Physical Therapy Assistant | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2018-01-29 |
1609392570 | Mark Eulenstein | Dentist | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2017-08-22 |
1306387436 | Carrie Marie Ferguson | Nurse Practitioner | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2017-03-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114554011 | Christina Dang | Student in an Organized Health Care Education/Training Program | 4355-b Faculty Drive, Us Air Force Academy, CO 80840 | 2020-03-23 |
1053893123 | Glen William Myers | Dentist | 2355-b Faculty Dr, Usaf Academy, Colorado, Usafa, AA 80840 | 2018-09-05 |
1225374499 | National Vision Optical | Technician/Technologist | Bldg 5136, Community Center Dr., Us Air Force Academy, CO 80840 | 2012-12-17 |
1366758906 | Brett Michael Germain | Dentist | 2355-b Faculty Dr., Usaf Academy, CO 80840 | 2010-08-20 |
1518289115 | Renee Jean Cole | Military Health Care Provider | 4515 East Juniper Dr Unit A, Usaf Academy, CO 80840 | 2010-02-23 |
1063655140 | Gregory S. Brooks | Military Health Care Provider | 2355 Faculty Dr Suite 1n207, 10th Amds, Usafa, CO 80840 | 2009-04-20 |
1801092390 | Bryant Mcneill | Internal Medicine | 4102 Pinion 10mdg, Usaf Academy, CO 80840 | 2007-06-22 |
1447384383 | Francis Crosby Jr. | Physician Assistant | 4102 Pinon Drive, Usaf Academy, CO 80840 | 2007-03-15 |
1023115870 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 5136 Eagle Dr, Ste 102, Usaf Academy, CO 80840 | 2006-09-20 |
1669582722 | Scott Layle Carbaugh | Physician Assistant | 4102 Pinion Dirve, Usaf Academy, CO 80840 | 2006-08-30 |
Find all providers in zip 80840 |
Taxonomy Code | 207XS0106X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Orthopaedic Surgery |
Specialization | Hand Surgery |
An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407461874 | Orthopedic Centers of Colorado, LLC | Orthopaedic Surgery | 3470 Centennial Blvd Ste 200, Colorado Springs, CO 80907-8669 | 2020-09-13 |
1912151457 | Panorama Orthopedics & Spine Center, PC | Orthopaedic Surgery | 660 Golden Ridge Road, Ste. 250, Panorama Orthopedics & Spine Center, PC, Golden, CO 80401-9541 | 2008-11-11 |
1770783581 | Elisa Jeanne Knutsen | Orthopaedic Surgery | 8890 N Union Blvd Ste 171, Colorado Springs, CO 80920-2701 | 2007-07-19 |
1487785408 | Meryl Singer Livermore | Orthopaedic Surgery | 777 Bannock St # Mc0188, Denver, CO 80204-4507 | 2007-03-08 |
1306881586 | Timothy J Pater | Orthopaedic Surgery | 1610 Dry Creek Drive, Ste 200, Longmont, CO 80503 | 2006-06-19 |
1710962758 | Allan W Bach | Orthopaedic Surgery | 3010 N Circle Dr, #100, Colorado Springs, CO 80909-1174 | 2005-12-13 |
1902881931 | Patrick D Devanny | Orthopaedic Surgery | 2960n Circle Dr 125, Colorado Springs, CO 80909-1164 | 2005-12-13 |
1659979383 | Lower Valley Hospital Association | Orthopaedic Surgery | 401 Kokopelli Blvd Ste 1, -practice Location Npi Only-, Fruita, CO 81521 | 2020-10-14 |
1265047443 | Orthopedic Centers of Colorado, LLC | Orthopaedic Surgery | 145 Inverness Dr E Ste 300, Englewood, CO 80112-5172 | 2020-09-14 |
1538639778 | Colorado Orthopedic Consultants PC | Orthopaedic Surgery | 401 W Hampden Pl Ste 220, Englewood, CO 80110-2471 | 2018-11-30 |
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City | USAF ACADEMY |
Zip Code | 80840 |
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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.