Individual provider Active NPI

Cynthia Jean Henry, DO

  • Pediatrics Physician
  • Portage, WI
National Provider Identifier
1144260712
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
44416 Issued in WI
Practice address
2817 New Pinery Rd
Portage, WI 53901-9240
Phone
(608) 742-4131
NPI assigned
Jun 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5101014794 MI
Pediatrics Physician 208000000X 44416 WI Primary

Addresses

Primary practice location

2817 New Pinery Rd
Portage, WI 53901-9240

Mailing address

2817 New Pinery Rd
Portage, WI 53901-9240
Phone (608) 742-4131

Other identifiers 2

IdentifierTypeStateIssuer
43506900MedicaidWI
3552210244OtherMIBLUE CROSS PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20051026000565 WI Practitioner - Pediatric Medicine 8426075714 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101014794MIMDPediatrics Physician
44416WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc Current Accepting new patients
Marshfield Clinic Inc CurrentSince May 20, 2019 Accepting new patients
MCHS Hospitals Inc CurrentSince May 20, 2019 Accepting new patients
MCHS Hospitals Inc CurrentSince May 20, 2019 Accepting new patients
Memorial Hospital Inc Past Accepting new patients

Locations

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

129 Old Abe Rd
Lac du Flambu, WI 54538
Phone (715) 588-3371

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

9576 State Highway 70
Minocqua, WI 54548
Phone (715) 358-1000

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

Interoperability endpoints

  • Direct secure messaging: cynthia.henry@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 5

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1144260712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY RD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019240",
            "telephone_number": "608-742-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY RD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019240",
            "telephone_number": "608-742-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "CYNTHIA",
        "middle_name": "JEAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101014794",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "44416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43506900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "3552210244",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portage, WI

Sources for this page

Verify at the official NPI Registry.