Therese Henry

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP60911627 Issued in WA

Practice address

1911 Cooks Hill Rd
Centralia, WA 98531-9073

Phone

(360) 736-6778

Fax

(360) 736-6552

NPI assigned

Sep 8, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Therese Hampton Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 20, 2022 through Apr 20, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: thenry@nwpc.opdirect.net

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548460800000",
    "number": "1083132161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 N 1100 E",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460779756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319073",
            "telephone_number": "360-736-6778",
            "fax_number": "360-736-6552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Lafayette Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462221147",
            "country_code": "US",
            "telephone_number": "317-291-7422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRY",
        "first_name": "THERESE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-08",
        "last_updated": "2019-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "28193241A",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP60911627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESE",
            "last_name": "HAMPTON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tylor Heilman, PHARMD
• Elizabeth Helder
• Michael Hellem
• Lacey Hemphill
• Heather Hennessey, RN
• Margaret Ruth Heriot, LMHC
• Natasha Marie Hernandez
• Adam Hewitt, LMP
• Amanda Kay Hiatt
• Nicholas Higa, DPT

• Pediatric Nurse Practitioner in Centralia, WA
• Providers in Centralia, WA by specialty
• Pediatric Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.