MARK SHEA HENDERSON (M.D.) – Surgery Physician, NPI 1639139876

MARK SHEA HENDERSON (M.D.) is a healthcare provider. based in Sikeston, Missouri. specializing in Surgery Physician. They hold the professional credentials M.D.. They hold a License No. J4200 (TX). The NPI Number for MARK SHEA HENDERSON (M.D.) is 1639139876

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
MARK SHEA HENDERSON (M.D.)
NPI
1639139876
Phone
(573) 472-6003
Address
135 PLAZA DR
Enumeration Date
23 March 2006
Last Update Date
24 January 2012

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
Secondary Phone
8326886111
Graduation Year
1992 (34 years ago)
PAC ID
1658348545
Group Practice PAC ID
2567706500
Professional Enrollment ID
I20080702000092
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for MARK SHEA HENDERSON (M.D.)

  • 135, Plaza Drive, Sikeston, Scott County, Missouri, 63801, United States

    SUITE 202

    SIKESTON, MO 638015136

    Phone: (573) 472-6003

    Fax: (573) 472-7159

    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: 2008-07-02

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
I20080702000092IGeneral SurgeryTXTBD

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 63801)

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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: 2567706500View full group profile
NameSpecialtyState
Orthopedic SurgeryTX
Interventional Radiology, Diagnostic RadiologyTX
Physical Medicine And RehabilitationPR

Reviews

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Frequently asked questions

Is MARK SHEA HENDERSON (M.D.) listed with a National Provider Identifier?
Yes — MARK SHEA HENDERSON (M.D.) has NPI 1639139876 on file in the registry.
Active or inactive — what applies to MARK SHEA HENDERSON (M.D.)?
You should see MARK SHEA HENDERSON (M.D.) as active in CMS-hosted NPPES data.
How would a patient describe MARK SHEA HENDERSON (M.D.)'s focus?
For MARK SHEA HENDERSON (M.D.), the primary taxonomy reads as Surgery Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MARK SHEA HENDERSON (M.D.)?
Travel planning: use Sikeston, Missouri as the reference point for MARK SHEA HENDERSON (M.D.), then confirm.
Does MARK SHEA HENDERSON (M.D.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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