HENDERSON FAMILY PRACTICE, INC
NPI 1629522032
Clinic/Center - Primary Care in Waycross, GA

Active since August 15, 2016CLIA 11D2118853 · Microscopy
624 TEBEAU ST, WAYCROSS, GA 31501(912) 809-6052(912) 809-6070 Get Directions Write a Review

NPPES record last updated: October 31, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Henderson Family Practice, Inc NPPES

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

HENDERSON FAMILY PRACTICE, INC (NPI 1629522032) is a healthcare organization registered as a primary care in Waycross, Georgia and active in the NPI registry since August 2016. The organization holds a CLIA Microscopy certificate valid through September 14, 2026 and lists Lori Tayman Henderson, Family Nurse Practitioner/owner, as its authorized official.

NPPES Registry Identity

NPI1629522032
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameHENDERSON FAMILY PRACTICE, INC
Location Address624 TEBEAU STWaycross, GA 31501-4728
Mailing Address403 Lister St, Suite AWaycross, GA 31501-5225 · (912) 283-4422 · Fax (912) 283-4866
Fax(912) 809-6070
Organization SubpartNo
Authorized OfficialLori Tayman HendersonFamily Nurse Practitioner/owner · (912) 809-6052
Enumeration DateAugust 15, 2016
Last NPPES UpdateOctober 31, 2024
NPPES CertifiedOctober 31, 2024
NPI 1629522032 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License Licensed in GA · RN133742
624 TEBEAU ST, Waycross, GA 31501

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

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 for Provider-Performed Microscopy Procedures (PPMP) 11D2118853

Henderson Family Practice · Waycross, GA
Active · expires Sep 14, 2026
CLIA Number11D2118853
Laboratory TypePractitioner Other
Certificate Effective DateSeptember 15, 2024
Certificate Expiration DateSeptember 14, 2026
Laboratory DirectorLori Henderson
Laboratory Phone(912) 809-6052
Laboratory LocationHenderson Family Practice624 Tebeau Street, Waycross, GA 31501
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 2

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

Nurse Practitioner (Family)
624 TEBEAU ST
WAYCROSS, GA 31501
Nurse Practitioner (Family)
624 TEBEAU ST
WAYCROSS, GA 31501

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 Family Practice, Inc's NPI number?

The NPI number for Henderson Family Practice, Inc is 1629522032. It was assigned to this organization in the NPPES registry on August 15, 2016.

Where is Henderson Family Practice, Inc located?

Henderson Family Practice, Inc is located at 624 Tebeau St, Waycross, GA 31501. The listed phone number is (912) 809-6052.

What is Henderson Family Practice, Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Henderson Family Practice, Inc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 11D2118853) is associated with this NPI, valid through September 14, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Henderson Family Practice, Inc accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Henderson Family Practice, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Henderson Family Practice, Inc was last updated on October 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.