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

NPI Status: Active since August 15, 2016

Contact Information

624 TEBEAU ST
WAYCROSS, GA
ZIP 31501
Phone: (912) 809-6052
Fax: (912) 809-6070

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  • Organization
  • Clinic/Center
  • Primary Care
  • Accepts Insurance
  • CLIA Number: 11D2118853
  • CLIA Cert. Type: Practitioner Other
  • CLIA Exp. Date: 09-14-2026

About HENDERSON FAMILY PRACTICE, INC

This page provides the complete NPI Profile along with additional information for Henderson Family Practice, Inc, a primary care provider established in Waycross, Georgia operating as a Clinic/center, focusing in primary care . The healthcare provider is registered in the NPI registry with number 1629522032 assigned on August 2016. The practitioner's primary taxonomy code is 261QP2300X with license number RN133742 (GA). The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Mrs. Lori Tayman Henderson Np-c (Family Nurse Practitioner/owner)

NPI
1629522032
Provider Name
HENDERSON FAMILY PRACTICE, INC
Entity Type
Organization
Location Address
624 TEBEAU ST WAYCROSS, GA 31501
Location Phone
(912) 809-6052
Location Fax
(912) 809-6070
Mailing Address
403 LISTER ST SUITE A WAYCROSS, GA 31501
Mailing Phone
(912) 283-4422
Mailing Fax
(912) 809-6070
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-15-2016
Last Update Date
10-31-2024
Code Navigator

A primary care provider (PCP) like Henderson Family Practice, Inc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Primary Care

Taxonomy Code
261QP2300X
Type
Ambulatory Health Care Facilities
License No.
RN133742
License State
GA

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Gold - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clarity Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Thrive Silver - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze with Atrium Health - HMO
  • Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Focused Silver with Atrium Health - HMO
  • Focused Silver with Atrium Health + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze with Atrium Health - HMO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. LORI TAYMAN HENDERSON NP-C

Authorized Official Title
FAMILY NURSE PRACTITIONER/OWNER
Authorized Official Phone
(912) 809-6052

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
11D2118853
Facility Type
Practitioner Other
Certificate Effective Date
September 15, 2024
Certificate Expiration Date
September 14, 2026
Laboratory Director
LORI HENDERSON
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Henderson Family Practice, Inc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1629522032, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
2
Doubled → 4
Pos 4
9
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
2
Unchanged
Pos 7
2
Doubled → 4
Pos 8
0
Unchanged
Pos 9
3
Doubled → 6
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 5 → 10 → 1 2 → 4 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 4 + 9 + 1 + 0 + 2 + 4 + 0 + 6 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1629522032.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

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

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1629522032, enumerated as an "organization" on August 15, 2016.

The provider is located at 624 TEBEAU ST WAYCROSS, GA 31501 and the phone number is (912) 809-6052.

Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter. Please consult your insurance carrier or call the provider to verify.