Jacqueline Lee Henry, APRN-NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10033768 Issued in OR

Practice address

6301 University Commons
South Bend, IN 46635-1571

Phone

(574) 251-1210

NPI assigned

Sep 24, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Jacqueline Lee Michuda Former name

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mosaic Community HealthGroup PAC ID 5395653497, 78 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmichuda733527@direct.ochin.org

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.

• Mosaic Community Health

  • Federally Qualified Health Center (FQHC)
  • Prineville, OR
  • NPI 1083633184
  Medicare reassignment Care Compare group NPD

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

• Cascade Healthcare Community Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Bend, OR
  • NPI 1164675963

  Hospital

  Care Compare affiliation
• St. Charles Health System, Inc.

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Care Compare affiliation

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1063239846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 UNIVERSITY COMMONS",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351571",
            "telephone_number": "574-251-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 UNIVERSITY COMMONS",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351571",
            "telephone_number": "574-251-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "JACQUELINE",
        "middle_name": "LEE",
        "credential": "APRN-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-24",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10033768",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "10033768",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28301774A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "MICHUDA",
            "middle_name": "LEE",
            "credential": "APRN-NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Victorianne Hendrickson
• Toni E Henke-Wheeler, LCSW
• Julenne Henriquez-Gil
• Henry County Memorial Hospital
• Angela Marie Henry, BA, MSW, LCSW
• Kody Carson-Michell Henry, RBT
• Tekona Henry, MSW
• Courtney Hensel, RN
• Renee L Hensley, PT
• Marcy L Herbert, RD

• Family Nurse Practitioner in South Bend, IN
• Providers in South Bend, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.