KERRY HENDERSON (MD) – Internal Medicine Physician, NPI 1407953839

KERRY HENDERSON (MD) is a healthcare provider. based in Atlanta, Georgia. specializing in Internal Medicine Physician. They hold the professional credentials MD. They hold a License No. ME0045810 (FL). The NPI Number for KERRY HENDERSON (MD) is 1407953839

Main info

Male
43 Years Of Experience
Accepts Medicare Assignment
Name
KERRY HENDERSON (MD)
NPI
1407953839
Phone
(352) 369-0948
Address
PO BOX 409036
Enumeration Date
20 September 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3523334900
Graduation Year
1983 (43 years ago)
PAC ID
0042305450
Group Practice PAC ID
6305988700
Professional Enrollment ID
I20071001000310
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for KERRY HENDERSON (MD)

  • PO BOX 409036

    ATLANTA, GA 303849036

    Phone: (352) 369-0948

    Fax: (904) 346-0113

    Type: Mailing

  • 6500, West Newberry Road, City of Gainesville Municipal Boundaries, Alachua County, Florida, 32669, United States

    GAINESVILLE, FL 326054309

    Phone: (352) 333-4900

    Fax: (904) 346-0113

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-10-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20071001000310IEmergency MedicineFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making247240$0
99284Emergency department visit with moderate level of medical decision making110109$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only4438$0
99291Critical care, first 30-74 minutes2929$0
99283Emergency department visit with low level of medical decision making1616$0
View full utilization report →

Insurance plans in this area (ZIP 30384)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6305988700View full group profile

Reviews

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Frequently asked questions

What is the registry number for KERRY HENDERSON (MD)?
The registry entry for KERRY HENDERSON (MD) shows NPI 1407953839.
Should I treat KERRY HENDERSON (MD) as an active provider?
Patients and plans typically see KERRY HENDERSON (MD) as active in the national extract.
What services align with KERRY HENDERSON (MD)'s listing?
KERRY HENDERSON (MD)'s public classification highlights Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Is KERRY HENDERSON (MD) tied to Atlanta, Georgia?
If you are local to Atlanta, Georgia, KERRY HENDERSON (MD) may be relevant to your search.
Why is information missing for KERRY HENDERSON (MD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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