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

Jacob Ray Henderson, DO

Individual provider Nephrology Physician · NPI 1487232401

Jacob Ray Henderson, DO is a Nephrology in Jacksonville, Florida. Qualified in 2021, 5 years ago. Practices with Mayo Clinic Jacksonville, a 1,581-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
5
Licensed in
FL
In the registry since
2021
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone: (904) 953-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2123 Auburn Ave Ste 235, Cincinnati, OH 45219-2906 — (513) 585-3238

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence OS21003 (FL)

Record details

NPI number1487232401
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 31, 2021
Last updated in NPPESOctober 21, 2024
Certification dateOctober 21, 2024
Mailing address4500 San Pablo Rd S, Jacksonville, FL 32224-1865

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEPHROLOGY
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Mayo Clinic Jacksonville — 1581 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Jacksonville