TAMARA HENDERSON – Family Nurse Practitioner, NPI 1114489879

TAMARA HENDERSON is a healthcare provider. based in Flint, Michigan. specializing in Family Nurse Practitioner. They hold a License No. 4704312000 (MI). The NPI Number for TAMARA HENDERSON is 1114489879

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
TAMARA HENDERSON
NPI
1114489879
Phone
(810) 309-9734
Address
G3494 BEECHER RD
Enumeration Date
2 April 2019
Last Update Date
2 April 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8106526333
Graduation Year
2018 (8 years ago)
PAC ID
5395086789
Group Practice PAC ID
6002183837
Professional Enrollment ID
I20190412000001
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

Provider Addresses for TAMARA HENDERSON

  • G3494 BEECHER RD

    FLINT, MI 485322735

    Phone: (810) 309-9734

    Mailing address matches the actual address.

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: 2019-04-12

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
I20190412000001INurse PractitionerMITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48532)

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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: 6002183837View full group profile

Reviews

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Frequently asked questions

How is TAMARA HENDERSON identified in CMS data?
CMS-hosted NPPES data lists TAMARA HENDERSON with NPI 1114489879.
Is TAMARA HENDERSON still practicing?
TAMARA HENDERSON is currently listed as active in the public NPI registry.
What is TAMARA HENDERSON best known for clinically?
Directory data describes TAMARA HENDERSON with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where should I expect TAMARA HENDERSON on a map?
Expect Flint, Michigan as a primary anchor for TAMARA HENDERSON unless the record lists multiple sites.
Why does TAMARA HENDERSON have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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