Cathie Sue Henneberry, F.N.P., APRN-BC, MSN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R36163 Issued in ND

Practice address

1213 15TH Ave W
Williston, ND 58801

Phone

(701) 572-7651

NPI assigned

Dec 30, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mrs. Cathie Sue Gwin-Henneberry Former name

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cathiehenneberry@cneb.allscriptsdirect.net

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

• Elite Specialty Clinics, Inc.

  dba Elite Health & Fitness

  • Physical Therapy Clinic/Center
  • Williston, ND
  • NPI 1841594900
  Medicare reassignment NPD
• Mercy Medical Center

  • Psychiatry Physician
  • Williston, ND
  • NPI 1801928593
  Medicare reassignment NPD
• Shamrock Family Practice LLC

  • Nurse Practitioner
  • Miles City, MT
  • NPI 1518983360
  NPD (past) Authorized official
• Elite Specialty Clinics, Inc.

  dba Elite Health

  • Urgent Care Clinic/Center
  • Williston, ND
  • NPI 1235481540
  NPD
• Mercy Home Care

  • Home Health Agency
  • Williston, ND
  • NPI 1871593723
  NPD
• Mercy Medical Center

  dba Chi St Alexius Health Williston

  • Critical Access Hospital
  • Williston, ND
  • NPI 1902824576
  NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1053398909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 15TH AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588013800",
            "telephone_number": "701-572-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 15TH AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "58801",
            "telephone_number": "701-572-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNEBERRY",
        "first_name": "CATHIE",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "F.N.P., APRN-BC, MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "RN26836",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R36163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1476052",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHIE",
            "last_name": "GWIN-HENNEBERRY",
            "middle_name": "SUE",
            "prefix": "MRS.",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Healing Hearts Therapy, LLC
• Health Source of Williston P.C.
• Kevin Cory Heath
• Elissa Beth Helmuth
• Kyle Helstad, PTA
• Carley Hennessy
• Mariah Herring, OTD, OTR/L
• Evonne A Hickok, FNP-C
• Jeanine Hicks, R.D.
• Tamara E Hilton, LSW

• Family Nurse Practitioner in Williston, ND
• Providers in Williston, ND by specialty
• Family Nurse Practitioner in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.