| James M Henderson Jr, CRNA | |
| 
					4800 48th St, Valley, AL 36854-3666  | |
| (334) 756-1848 | |
| (334) 756-1854 | 
| Full Name | James M Henderson Jr | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Anesthetist, Certified Registered | 
| Location | 4800 48th St, Valley, Alabama | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1972568855 | NPI | - | NPPES | 
| 1972568855 | Other | AL | TRICARE STANDARD | 
| 842124961A | Medicaid | GA | |
| 1972568855 | Other | GA | BC BS OF GA | 
| P00135447 | Other | AL | RAILROAD MEDICARE | 
| 051517972 | Medicaid | AL | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 1-031733 (Alabama) | Secondary | 
| 367500000X | Nurse Anesthetist, Certified Registered | RN050883 (Georgia) | Primary | 
| Entity Name | Emory Specialty Associates, Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1407864168 PECOS PAC ID: 3476559782 Enrollment ID: O20061010000447  | 
| Mailing Address | Practice Location Address | 
|---|---|
| James M Henderson Jr, CRNA Po Box 661495, Birmingham, AL 35266-1495 Ph: (205) 979-5882  | James M Henderson Jr, CRNA 4800 48th St, Valley, AL 36854-3666 Ph: (334) 756-1848  | 
Thomas M Nichols, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 4800 48th St, Valley, AL 36854 Phone: 334-756-1848 Fax: 334-756-1854  | |
Mr. Gary Russell Mills, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4800 48th St, Valley, AL 36854 Phone: 256-283-7878  | |
Heather Laconya Veal Fields, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4800 48th St, Valley, AL 36854 Phone: 334-756-1848 Fax: 334-756-1854  | |
Charles Derrick Wilson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4800 48th St, Valley, AL 36854 Phone: 334-756-1848 Fax: 334-756-1854  |