JOHNNY (BLAINE) HENDERSON MD
NPI 1659492627
Psychiatry & Neurology - Psychiatry in Flagstaff, AZ

Q: What is Johnny (blaine) Henderson's NPI number?

The NPI number for Johnny (blaine) Henderson is 1659492627. It was assigned to this individual provider in the NPPES registry on April 3, 2007.

Q: What is Johnny (blaine) Henderson's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Active since April 03, 2007PECOS EnrolledAccepts Medicare Assignment

77.01/100

CMS Quality Rating

1200 N BEAVER ST, FLAGSTAFF, AZ 86001(928) 213-6415(928) 213-6409 Get Directions Write a Review

NPPES record last updated: December 18, 2015. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Dec 18, 2015, Nov 24, 2015, Nov 17, 2015 (3 updates tracked since 2015).

On this page

About Johnny (blaine) Henderson Md NPPES

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

JOHNNY (BLAINE) HENDERSON MD (NPI 1659492627) is an individual psychiatry provider in Flagstaff, Arizona, licensed in Arizona (48599) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS and is a graduate of Texas Tech University Health Science Center School Of Medicine (2005).

NPPES Registry Identity

NPI1659492627

Entity TypeIndividualMale

Primary Taxonomy2084P0800X

Provider Legal NameJOHNNY (BLAINE) HENDERSONCredential: MD

Location Address1200 N BEAVER STFlagstaff, AZ 86001-3118

Mailing Address1200 N Beaver St, Payer CredentialingFlagstaff, AZ 86001-3118 · (928) 773-2559 · Fax (928) 213-6292

Phone(928) 213-6415

Fax(928) 213-6409

Sole ProprietorNo

Medical School CMSTexas Tech University Health Science Center School Of MedicineGraduated 2005

Enumeration DateApril 3, 2007

Last NPPES UpdateDecember 18, 20153 updates tracked since enumeration

✔ NPI 1659492627 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

License✔ Licensed in AZ · 48599

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

1200 N BEAVER ST, Flagstaff, AZ 86001

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Other Identifiers 2

Medicare PINZ164514AZ

Medicaid879791AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Johnny (blaine) Henderson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1658444096

PECOS Enrollment IDI20140430001464

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 86001 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$168.60 typical visit price

range $55.44 – $168.60

Typical copayment $42.15 (range $13.86 – $42.15)

Most-billed visit code 99205

Established Patient

$69.24 typical visit price

range $17.72 – $137.41

Typical copayment $17.31 (range $4.43 – $34.35)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

77.01/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

59.66

Promoting Interoperability

100

Improvement Activities

Cost

63.71

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.

DR. JEREMY NIELSEN M.D.

Anesthesiology

1200 N BEAVER ST
FLAGSTAFF, AZ 86001

Coconino County (928) 779-3366

DR. SEAN DANIEL WOODS M.D.

Pediatrics (Neonatal-Perinatal Medicine)

1200 N BEAVER ST
FLAGSTAFF, AZ 86001

Coconino County (928) 773-2112

ELIZABETH GILMORE CRNA

Nurse Anesthetist, Certified Registered

1200 N BEAVER ST
FLAGSTAFF, AZ 86001

Coconino County (928) 779-3366

TANYA LEE MORGAN TWEED RDN

Dietitian, Registered

1200 N BEAVER ST
FLAGSTAFF, AZ 86001

Coconino County (928) 773-2441

THOMAS MATTHEW REEVE MD

Emergency Medicine

1200 N BEAVER ST
FLAGSTAFF, AZ 86001

Coconino County (210) 464-7442

MS. SUSAN POMEROY BASSETT M.S.

Audiologist

1200 N BEAVER ST, AUDIOLOGY DEPARTMENT
FLAGSTAFF, AZ 86001

Coconino County (928) 214-3728

DR. ALI I RAJA MD, MSC

Neurological Surgery

1200 N BEAVER ST
FLAGSTAFF, AZ 86001

Coconino County (928) 779-3366

LEAH MARIE COFFMAN PAUL CRNA

Nurse Anesthetist, Certified Registered

1200 N BEAVER ST
FLAGSTAFF, AZ 86001

Coconino County (928) 779-3366

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 Johnny (blaine) Henderson's NPI number?

The NPI number for Johnny (blaine) Henderson is 1659492627. It was assigned to this individual provider in the NPPES registry on April 3, 2007.

Where is Johnny (blaine) Henderson located?

Johnny (blaine) Henderson practices at 1200 N Beaver St, Flagstaff, AZ 86001. The listed phone number is (928) 213-6415.

What is Johnny (blaine) Henderson's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Johnny (blaine) Henderson enrolled in Medicare?

Yes. Johnny (blaine) Henderson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Johnny (blaine) Henderson accept?

Health plans from Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc. and UnitedHealthcare list Johnny (blaine) Henderson 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 Johnny (blaine) Henderson was last updated on December 18, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.