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MARK SHEA HENDERSON M.D. NPI 1639139876


NPI Information

NPI: 1639139876
Provider Name: MARK SHEA HENDERSON, M.D.
Classification: Surgery - 208600000X
Entity Type: Individual

PECOS Registration: Yes

Address:
135 PLAZA DR
SUITE 202
SIKESTON, MO
ZIP 63801
Phone: (573) 472-6003
Get Directions

Mark Shea Henderson, M.D. is a surgery in Sikeston, MO. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. Mark Shea Henderson, M.D. NPI is 1639139876. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

135 PLAZA DR
SUITE 202
SIKESTON, MO
ZIP 63801-136
Phone: (573) 472-6003
Fax: (573) 472-7159

The NPI 1639139876 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 3/23/2006 and was last updated on 1/24/2012.


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
1208600000XSurgeryJ4200TEXASYes

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
18L13411MEDICARE PINTEXAS
2990010000OTHERTEXASMCARE RR
38L13371MEDICARE PINTEXAS
4113358906MEDICAIDTEXAS
5113358905MEDICAIDTEXAS
68L13372MEDICARE PINTEXAS
78K7942MEDICARE PIN
8G10866MEDICARE UPINTEXAS
9113358901MEDICAIDTEXAS
10113358907MEDICAIDTEXAS
110021BPMEDICARE PINTEXAS
128BF145OTHERTEXASBCBS

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.