Individual provider Active NPI

Melissa Jo Henke, M.D.

  • Psychiatry Physician
  • Mandan, ND
National Provider Identifier
1083734172
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
9938 Issued in ND
Practice address
2372 Harmon LN N
Mandan, ND 58554-8271
Phone
(701) 214-7442
Fax
(701) 751-5705
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 9938 ND Primary

Addresses

Primary practice location

2372 Harmon LN N
Mandan, ND 58554-8271

Mailing address

PO Box 661
Mandan, ND 58554-0661
Phone (701) 214-7442

Other identifiers 1

IdentifierTypeStateIssuer
14408MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Heartview Foundation Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Heartview Foundation Dickinson PastSince Feb 19, 2023 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1083734172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585540661",
            "telephone_number": "701-214-7442",
            "fax_number": "701-751-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2372 HARMON LN N",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585548271",
            "telephone_number": "701-214-7442",
            "fax_number": "701-751-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKE",
        "first_name": "MELISSA",
        "middle_name": "JO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ND",
            "license": "9938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14408",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandan, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.