KATHRYN ANN HENDERSON D.O. NPI 1710949417

NPI Information

NPI: 1710949417
Provider Name: KATHRYN ANN HENDERSON, D.O.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
19 MYRTLE ST
MEDFORD, OR
ZIP 97504
Phone: (541) 842-7626
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Kathryn Ann Henderson, D.O. is a family medicine in Medford, OR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Kathryn Ann Henderson, D.O. NPI is 1710949417. 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:

19 MYRTLE ST
MEDFORD, OR
ZIP 97504-337
Phone: (541) 842-7626
Fax: (541) 842-7640

The enumeration date for this NPI number is 4/6/2006 and was last updated on 3/12/2013.

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	207P00000X	Emergency Medicine		D013513	OREGON	No
2	207Q00000X	Family Medicine		DO13513	OREGON	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	930079054	OTHER		RAILROAD MEDICARE
2	97520A005	OTHER		CHAMPUS
3	E68602	OTHER		GROUP HEALTH
4	E68602	OTHER		PROVIDENCE HEALTH PLAN
5	023507000	OTHER	OREGON	BC/BS OF OREGON
6	E68602	MEDICARE UPIN
7	XPY185059	MEDICAID	CALIFORNIA
8	R104103	MEDICARE PIN

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: 4/28/2024

NPI Synchronization or Removal

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