Dr Governor Henry Henderson Iii, DNP is a medicare enrolled "Nurse Practitioner - Family" physician in Sierra Vista, Arizona. He graduated from medical school in 2018 and has 7 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Sierra Vista Regional Health Center Medical Group Llc and his current practice location is
75 Colonia De Salud # 200, Sierra Vista, Arizona. You can reach out to his office (for appointments etc.) via phone at
(520) 263-2690.
Dr Governor Henry Henderson Iii is licensed to practice in Georgia (license number RN252065) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1538639497.
Physician's Profile
| Full Name | Dr Governor Henry Henderson Iii |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 7 Years |
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| Location | 75 Colonia De Salud # 200, Sierra Vista, Arizona |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Governor Henry Henderson Iii graduated from medical school in 2018
NPI Data:
- NPI Number: 1538639497
- Provider Enumeration Date: 12/04/2018
- Last Update Date: 04/01/2023
Medicare PECOS Information:
- PECOS PAC ID: 4981947546
- Enrollment ID: I20230413000180
Medical Identifiers
Medical identifiers for Dr Governor Henry Henderson Iii such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1538639497 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208800000X | Urology | RN252065 (Georgia) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 288860 (Arizona) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | RN252065 (Georgia) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Sierra Vista Regional Health Center Medical Group Llc | 3779732854 | 38 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Governor Henry Henderson Iii allows following entities to bill medicare on his behalf.
| Entity Name | Sierra Vista Regional Health Center Medical Group Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1043575483
PECOS PAC ID: 3779732854
Enrollment ID: O20121004000679 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Governor Henry Henderson Iii is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Governor Henry Henderson Iii, DNP
75 Colonia De Salud # 200,
Sierra Vista, AZ 85635-2487
Ph: (520) 263-2690 | Dr Governor Henry Henderson Iii, DNP
75 Colonia De Salud # 200,
Sierra Vista, AZ 85635-2487
Ph: (520) 263-2690 |
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