Kristi Noel Hennan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A94660 Issued in CA

Practice address

19 Myrtle St
Medford, OR 97504-7337

Phone

(541) 773-3863

Fax

(541) 776-2892

NPI assigned

Jul 31, 2006

Last updated

Jun 11, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

University of Vermont College of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DHS Office of Financial Services Irs Eopc BMRC Eotc Osh Osh-PGroup PAC ID 0547170383, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• DHS/Office of Financial Services Irs/Eopc/BMRC/Eotc/Osh/Osh-P

  dba Oregon State Hospital (Salem)

  • Psychiatric Hospital
  • Salem, OR
  • NPI 1508802489
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1093720476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 MYRTLE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047337",
            "telephone_number": "541-773-3863",
            "fax_number": "541-776-2892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 MYRTLE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047337",
            "telephone_number": "541-773-3863",
            "fax_number": "541-776-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNAN",
        "first_name": "KRISTI",
        "middle_name": "NOEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A94660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer M Henderson, MS, LPC
• Kathryn Ann Henderson, D.O.
• Robyn M Henderson, L.M.T.
• Shannon Henderson, NP
• Sara Kay Hendricksom, PHARM D
• Carolyn Ann Hennessey, M.A., LMFT
• Henry Harbert DMD LLC
• Evelyn L Henry, MD
• Hayley Renee Henry, NP
• Jill Henry, PA

• Family Medicine Physician in Medford, OR
• Providers in Medford, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.