Individual provider Active NPI

Meghan Henningsen, D.O.

  • Family Medicine Physician
  • Chesterfield, MO
National Provider Identifier
1013368455
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2016020851 Issued in MO
Practice address
17417 Chesterfield Airport Rd
Chesterfield, MO 63005-1308
Phone
(366) 857-7246
NPI assigned
Jun 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2016020851 MO Primary

Addresses

Primary practice location

17417 Chesterfield Airport Rd
Chesterfield, MO 63005-1308

Mailing address

2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190907000214 MO Practitioner - Family Practice 7810289642 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Physicians and Surgeons, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tri-County Family Practice, LLCGroup PAC ID 5294769238, 9 clinicians

Practice addresses (Care Compare)

17417 Chesterfield Airport Rd
Chesterfield, MO 63005-1308
Phone (636) 685-7724

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
  • SSM St Joseph Hospital West Hospital, Lake Saint Louis, MO, CCN 260200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2016020851MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of St. Luke'S, LLC Family Medicine CurrentSince Jul 27, 2019 Accepting new patients
Physician Specialists of St Lukes LLC Family Medicine Past Accepting new patients
Cardiothoracic Surgery, LLC PastSince Aug 12, 2019 Accepting new patients

Locations

17421 Chesterfield Airport Rd
Chesterfield, MO 63005
Phone (636) 685-7720

233 Clarkson Rd
Ellisville, MO 63011
Phone (636) 256-8644

2345 Dougherty Ferry Rd
Saint Louis, MO 63122
Phone (314) 821-5850

Networks

  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • IL PPO Downstate

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1013368455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 DOUGHERTY FERRY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17417 CHESTERFIELD AIRPORT RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051308",
            "telephone_number": "366-857-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNINGSEN",
        "first_name": "MEGHAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2016020851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.