STEPHANIE RENEE CARSON HENDERSON (NPI# 1952386104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952386104 |
| Entity Type | Individual |
| Full Name | STEPHANIE RENEE CARSON HENDERSON |
| Credential | MD |
| Practice Address |
1201 S Main St Fort Worth TX 76104-4804 |
| Mailing Address |
Po Box 732973 Dallas TX 75373-2973 |
| Practice Telephone | 8177026500 |
| Practice Fax Number | 8179276559 |
| Mailing Telephone | 8177022450 |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2018-10-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | L4878 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 8DP282 | 01 |
| TX | BCBS | 8A0452 | 01 |
| TX | RAILROAD MEDICARE | P01379268 | 01 |
| TX | 157818903 | 05 | |
| TX | 1578189-01 | 05 |
| Street Address |
1201 S MAIN ST |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-4804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730591611 | Audra Wellington | Lactation Consultant, Non-RN | 1201 S Main St, Fort Worth, TX 76104-4804 | 2014-05-27 |
| 1588076483 | Ann Palagi-pate | Nurse Practitioner | 1201 S Main St, Fort Worth, TX 76104-4804 | 2014-05-27 |
| 1962822791 | Brett Robert Westbrook | Obstetrics & Gynecology | 1201 S Main St, Fort Worth, TX 76104-4804 | 2014-04-19 |
| 1164784450 | Gennady G Miroshnichenko | Obstetrics & Gynecology | 1201 S Main St, Fort Worth, TX 76104-4804 | 2012-06-12 |
| 1891080404 | Aurora Bustillos | Registered Nurse | 1201 S Main St, Fort Worth, TX 76104-4804 | 2011-06-10 |
| 1184917841 | Emily Elizabeth Hadley | Obstetrics & Gynecology | 1201 S Main St, Fort Worth, TX 76104 | 2011-05-27 |
| 1649336074 | Rachel C Hyde | Advanced Practice Midwife | 1201 S Main St, Fort Worth, TX 76104-4804 | 2006-12-29 |
| 1356329205 | Elizabeth Golladay Spooner | Obstetrics & Gynecology | 1201 S Main St, Fort Worth, TX 76104-4804 | 2006-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| 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 Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619481637 | Jonathan C. Snead, Md, Pa Dba: Alliance Women's Healthcare | Obstetrics & Gynecology | 10932 N Riverside Dr Ste 100, Fort Worth, TX 76244-7137 | 2017-11-29 |
| 1356888788 | Karen Benz, Md Pa | Obstetrics & Gynecology | 1250 8th Ave Ste 270, Fort Worth, TX 76104-4139 | 2017-01-24 |
| 1164895355 | Steven R. Edmondson Md, Pa | Obstetrics & Gynecology | 3025 N Tarrant Pkwy Ste 240, Fort Worth, TX 76177-8620 | 2015-11-10 |
| 1437542982 | Charles David Braungardt | Obstetrics & Gynecology | 7221 Meadowbrook Dr, Fort Worth, TX 76112-5327 | 2015-03-09 |
| 1962840678 | Madeline Manning | Obstetrics & Gynecology | 6100 Harris Pkwy Ste 235, Fort Worth, TX 76132-4126 | 2013-06-05 |
| 1720378375 | Melissa A Weidert | Obstetrics & Gynecology | 1000 Bonnie Brae Ave, Fort Worth, TX 76111-4301 | 2011-04-17 |
| 1396061826 | Deana Jamal Hussamy | Obstetrics & Gynecology | 1325 Pennsylvania Ave Ste 600, Fort Worth, TX 76104-2133 | 2010-04-08 |
| 1790001360 | Christopher Mark Ripperda | Obstetrics & Gynecology | 1250 8th Ave Ste 330, Fort Worth, TX 76104-4148 | 2010-04-07 |
| 1063744142 | Linda M Bernstein | Obstetrics & Gynecology | 7229 Hawkins View Dr, Fort Worth, TX 76132-3921 | 2010-02-01 |
| 1104157106 | Remedios R. Cabansag, Md, Pa | Obstetrics & Gynecology | 11803 So. Freeway, Suite 254, Fort Worth, TX 76115-0337 | 2010-01-15 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
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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.