NPI Code Detail JSON Logo

1790928745 NPI number — JEFFREY THOMAS HENSON MD

NPI Number: 1790928745
Health Care Provider/Practitioner: JEFFREY THOMAS HENSON MD

Information about “1790928745” NPI (JEFFREY THOMAS HENSON MD) exists in 1790928745 in HTML format HTML  |  1790928745 in plain Text format TXT  |  1790928745 in PDF (Portable Document Format) PDF  |  1790928745 in an XML format XML  formats.

NPI Number : 1790928745 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1790928745",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HENSON",
    "FirstName": "JEFFREY",
    "MiddleName": "THOMAS",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HENSON",
    "OtherFirstName": "JEFF",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "806 JACKSON ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COLUMBUS",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "47201-6264",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "812-799-3288",
    "MailingAddressFaxNumber": "515-358-5951",
    "FirstLinePracticeLocationAddress": "806 JACKSON ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "COLUMBUS",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "47201-6264",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "812-799-3288",
    "PracticeLocationAddressFaxNumber": "515-358-5951",
    "EnumerationDate": "04/07/2009",
    "LastUpdateDate": "04/13/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2083P0500X",
          "TaxonomyName": "Preventive Medicine/Occupational Environmental Medicine Physician",
          "LicenseNumber": "01086950A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208D00000X",
          "TaxonomyName": "General Practice Physician",
          "LicenseNumber": "46989",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2083P0500X",
          "TaxonomyName": "Preventive Medicine/Occupational Environmental Medicine Physician",
          "LicenseNumber": "MD-44484",
          "LicenseNumberStateCode": "IA",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "MD-44484",
          "LicenseNumberStateCode": "IA",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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