=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346198694
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WHOOP PHYSICIAN SERVICES, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2026
-----------------------------------------------------
Last Update Date | 03/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 KENMORE SQ
-----------------------------------------------------
City | BOSTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02215-2039
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-816-1877
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 KENMORE SQ
-----------------------------------------------------
City | BOSTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02215-2039
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-816-1877
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DIRECTOR
-----------------------------------------------------
Name | DR. DANIEL HENDERSON
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 617-816-1877
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------