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HENDERSON HOSPITAL, LLC
NPI 1043710437
Internal Medicine in Henderson, TX

Active since February 13, 2018CLIA Certified · 2 labs
300 WILSON ST, HENDERSON, TX 75652(903) 655-6536(903) 657-6072 Get Directions Write a Review

NPPES record last updated: February 13, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Henderson Hospital, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HENDERSON HOSPITAL, LLC (NPI 1043710437) is a healthcare organization registered as an internal medicine in Henderson, Texas and active in the NPI registry since February 2018. The organization holds 2 active CLIA laboratory certificates and lists Stephen C. Petrovich, Evp, as its authorized official.

NPPES Registry Identity

NPI1043710437
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameHENDERSON HOSPITAL, LLC
Location Address300 WILSON STHenderson, TX 75652-5956
Mailing Address1 Burton Hills Blvd Ste 250Nashville, TN 37215-6195 · (615) 296-3000 · Fax (615) 296-6227
Phone(903) 655-6536
Fax(903) 657-6072
Organization SubpartNo
Authorized OfficialStephen C. PetrovichEvp · (615) 296-3000
Enumeration DateFebruary 13, 2018
✔ NPI 1043710437 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
300 WILSON ST, Henderson, TX 75652
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 45D0482903

Henderson Hospital, LLC · Henderson, TX
Active · expires Jan 2, 2027
CLIA Number45D0482903
Laboratory TypeHospital
Certificate Effective DateJanuary 3, 2025
Certificate Expiration DateJanuary 2, 2027
Laboratory DirectorLorenz Schmiege
Laboratory Phone(903) 655-3737
Laboratory LocationHenderson Hospital, LLC300 Wilson Street, Henderson, TX 75652
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 45D0919364

Henderson Hospital, LLC · Henderson, TX
Active · expires Dec 31, 2026
CLIA Number45D0919364
Laboratory TypeCommunity Clinic
Certificate Effective DateJanuary 1, 2025
Certificate Expiration DateDecember 31, 2026
Laboratory DirectorGlena J. Davis
Laboratory Phone(903) 655-3633
Laboratory LocationHenderson Hospital, LLC300 Wilson Street, Suite 2E, Henderson, TX 75652
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICA LADON NORMAN PMHNP-BC, FNP-C
Nurse Practitioner (Psychiatric/Mental Health)
300 WILSON ST
HENDERSON, TX 75652
Rusk County (903) 655-6536
EAST TEXAS MEDICAL CENTER HENDERSON
Nurse Anesthetist, Certified Registered
300 WILSON ST
HENDERSON, TX 75652
Rusk County (903) 657-7541
ADAM RANGINWALA MD
Emergency Medicine
300 WILSON ST
HENDERSON, TX 75652
Rusk County (615) 665-1283
HENDERSON MEMORIAL HOSPITAL
Emergency Medicine
300 WILSON ST
HENDERSON, TX 75652
Rusk County (903) 675-7541
HENDERSON MEMORIAL HOSPITAL
Clinic/Center
300 WILSON ST
HENDERSON, TX 75652
Rusk County (903) 657-7541
TANAGER EMERGENCY PHYSICIANS PLLC
Emergency Medicine
300 WILSON ST
HENDERSON, TX 75652
Rusk County (954) 838-2371
DR. CHERYL ANN POLKOWSKI M.D.
Family Medicine
300 WILSON ST
HENDERSON, TX 75652
Rusk County (903) 655-6536
AMANDA KAYE TRUBEY MSN, FNP-C
Nurse Practitioner (Family)
300 WILSON ST
HENDERSON, TX 75652
Rusk County (903) 646-4834

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Henderson Hospital, LLC's NPI number?

The NPI number for Henderson Hospital, LLC is 1043710437. It was assigned to this organization in the NPPES registry on February 13, 2018.

Where is Henderson Hospital, LLC located?

Henderson Hospital, LLC is located at 300 Wilson St, Henderson, TX 75652. The listed phone number is (903) 655-6536.

What is Henderson Hospital, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Henderson Hospital, LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Henderson Hospital, LLC was last updated on February 13, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.