Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Island Medical Henderson LLC

Organization Emergency Medicine Physician · NPI 1619490778

Island Medical Henderson LLC is an Emergency Medicine Physician in Henderson, Kentucky. Registered with an NPI since 2017.

In the registry since
2017
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1305 N Elm St
Henderson, KY 42420-2783
Phone: (406) 862-3002
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X
Physician Assistant Taxonomy 363A00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1619490778
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michaelamy Charley — Chief Legal Officer · (240) 686-2300
NPI enumeratedJuly 20, 2017
Last updated in NPPESJune 3, 2020
Certification dateJune 3, 2020
Mailing address12420 Milestone Center Dr Ste 200, Germantown, MD 20876-7111

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