Individual provider

Tracy Henderson, MD

Sports Medicine (Family Medicine) Physician Sports Medicine (Internal Medicine) Physician Sports Medicine (Orthopaedic Surgery) Physician Medicare enrolled

Tracy Henderson, MD is a Sports Medicine (Family Medicine) Physician in Willow Park, TX, registered under NPI 1073839817. This provider registers 4 separate taxonomy codes, which usually means they practise across more than one recognised specialty.

Getting there

The practice address on file is 110 MARY LOU DRIVE SUITE 100, Willow Park, TX 76087. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

110 MARY LOU DRIVE SUITE 100, Willow Park, TX 76087 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
T8117 TX Sports Medicine (Family Medicine)… primary
T8117 TX Sports Medicine (Internal Medicine)…
MD60450293 WA Sports Medicine (Orthopaedic Surgery)…
T8117 TX Sports Medicine (Physical Medicine &…

Licences are recorded in 2 states: TX, WA. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Sports Medicine
PAC ID
8022237676
Enrollment ID
I20230706000199

Medicare enrolment is recorded as approved under the provider type Practitioner - Sports Medicine. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: Texas and Washington. The practice address on file is in Willow Park, TX, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

TX Texas practice address
Licence
T8117
Specialty
Sports Medicine (Family Medicine)…
Verify with the TX board →
WA Washington
Licence
MD60450293
Specialty
Sports Medicine (Orthopaedic Surgery)…
Verify with the WA board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Sports Medicine covers

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. NUCC Health Care Provider Taxonomy, code 207QS0010X
Allopathic & Osteopathic Physicians Family Medicine Sports Medicine

All registered taxonomy codes

This provider registers 4 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
207QS0010X Sports Medicine (Family Medicine) Physician Sports Medicine T8117 TX primary
207RS0010X Sports Medicine (Internal Medicine) Physician Sports Medicine T8117 TX
207XX0005X Sports Medicine (Orthopaedic Surgery) Physician Sports Medicine MD60450293 WA
2081S0010X Sports Medicine (Physical Medicine & Rehabilitation) Physician Sports Medicine T8117 TX

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1073839817 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateApr 19, 2010
Last updatedJan 10, 2024
StatusActive
Sole proprietorNo
CredentialMD
Practice address 110 MARY LOU DRIVE
SUITE 100
Willow Park, TX 76087
(817) 930-2030
Mailing address 110 MARY LOU DR STE 100
Willow Park, TX 76087
This record was updated on Jan 10, 2024, which is recent enough that the contact details are likely still accurate.

Number check

1073839817 passes the NPI check digit test The final digit 7 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 0 7 3 8 3 9 8 1
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 0 5 3 7 3 9 8 2

Sum = 63 · next multiple of 10 = 70 · check digit = 7 · actual last digit = 7

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1073839817?
NPI 1073839817 is the National Provider Identifier assigned to Tracy Henderson, MD in Willow Park, TX. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Sports Medicine cover?
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the…
How do I contact Tracy Henderson, MD?
The phone number on file with NPPES is (817) 930-2030, last updated Jan 10, 2024. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Tracy Henderson, MD accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1073839817 a valid number?
Yes. 1073839817 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.