Holly Jo Henderson, MPT is a medicare enrolled "Nurse Practitioner - Family" in Golden, Illinois. She went to Southern Illinois University School Of Medicine and graduated in 2019 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Blessing Hospital and her current practice location is
102 Prairie Mills Rd, Golden, Illinois. You can reach out to her office (for appointments etc.) via phone at
(217) 696-4446.
Holly Jo Henderson is licensed to practice in Illinois (license number 209020158) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1710034954.
Provider's Profile
| Full Name | Holly Jo Henderson |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 6 Years |
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| Location | 102 Prairie Mills Rd, Golden, Illinois |
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| Accepts Medicare Assignments | Yes. She 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:
- Holly Jo Henderson attended and graduated from Southern Illinois University School Of Medicine in 2019
NPI Data:
- NPI Number: 1710034954
- Provider Enumeration Date: 01/03/2007
- Last Update Date: 01/31/2020
Medicare PECOS Information:
- PECOS PAC ID: 5496991457
- Enrollment ID: I20201030000880
Medical Identifiers
Medical identifiers for Holly Jo Henderson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1710034954 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 209020158 (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Blessing Hospital | 3072422534 | 369 |
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. Holly Jo Henderson allows following entities to bill medicare on her behalf.
| Entity Name | Blessing Corporate Services, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1720186265
PECOS PAC ID: 5991616138
Enrollment ID: O20040116000382 |
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| Entity Name | Blessingcare Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992038640
PECOS PAC ID: 2769420959
Enrollment ID: O20050419000684 |
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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. Holly Jo Henderson 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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Holly Jo Henderson, MPT
183 Saturn Dr,
Hannibal, MO 63401-2398
Ph: (573) 795-0849 | Holly Jo Henderson, MPT
102 Prairie Mills Rd,
Golden, IL 62339-1055
Ph: (217) 696-4446 |
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