Kimberly Ann Henderson, MA is a medicare enrolled "Physician Assistant - Medical" provider in Charlotte, North Carolina. Her current practice location is
501 S Sharon Amity Rd Ste 300, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(704) 377-2424.
Kimberly Ann Henderson is licensed to practice in North Carolina (license number 0010-06963) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1538340641.
Healthcare Provider's Profile
Full Name | Kimberly Ann Henderson |
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Gender | Female |
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Speciality | Physician Assistant - Medical |
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Location | 501 S Sharon Amity Rd Ste 300, Charlotte, North Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1538340641
- Provider Enumeration Date: 11/16/2007
- Last Update Date: 02/02/2021
Medicare PECOS Information:
- PECOS PAC ID: 9436433513
- Enrollment ID: I20170309001772
Medical Identifiers
Medical identifiers for Kimberly Ann Henderson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1538340641 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
363A00000X | Physician Assistant | 0010-06963 (North Carolina) | Secondary |
363AM0700X | Physician Assistant - Medical | 0010-06963 (North Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberly Ann Henderson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kimberly Ann Henderson, MA 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211-0035 Ph: (704) 377-2424 | Kimberly Ann Henderson, MA 501 S Sharon Amity Rd Ste 300, Charlotte, NC 28211-0035 Ph: (704) 377-2424 |
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