SUSAN MARIE HENDERSON PA-C NPI 1184753063

NPI Information

NPI: 1184753063
Provider Name: SUSAN MARIE HENDERSON, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: HAMPTON REGIONAL MEDICAL CENTER

PECOS Registration: Yes

Address:
595 W CAROLINA AVE
VARNVILLE, SC
ZIP 29944
Phone: (803) 943-7612
Get Directions

Susan Marie Henderson, PA-C is a medical physician assistant in Varnville, SC with 29 years of experience. Susan Marie Henderson, PA-C NPI is 1184753063. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

595 W CAROLINA AVE
VARNVILLE, SC
ZIP 29944-735
Phone: (803) 943-7612

The NPI 1184753063 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/5/2007 and was last updated on 3/7/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	MA002063L	PENNSYLVANIA	No
2	363AM0700X	Physician Assistant	Medical	TL1507	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	SC08339402	OTHER	SOUTH CAROLINA	PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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