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

Kelly G. Henderson, PA

Individual provider Physician Assistant · NPI 1154337517

Kelly G. Henderson, PA is a Physician Assistant in Overland Park, Kansas. Qualified in 1999, 27 years ago. Practices with Overland Park Surgical Specialties LLC, a 88-clinician group and accepts Medicare assignment. Licensed in Kansas.

Years since qualifying
27
Licensed in
KS
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

11725 W 112th St
Overland Park, KS 66210-2761
Phone: (913) 469-5579
Fax: (913) 338-1311
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 15-00672 (KS)

Record details

NPI number1154337517
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 31, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Overland Park Surgical Specialties Llc — 88 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Overland Park