Douglas R Henneberg, ATC

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

001092 Issued in NY

Practice address

1000 E Henrietta Rd
Rochester, NY 14623-5701

Phone

(585) 292-2848

NPI assigned

May 17, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1164096962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E HENRIETTA RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146235701",
            "telephone_number": "585-292-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E HENRIETTA RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146235701",
            "telephone_number": "585-292-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNEBERG",
        "first_name": "DOUGLAS",
        "middle_name": "R",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NY",
            "license": "001092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "WEBSTER",
            "affiliation": "N",
            "address_1": "1555 Barrow Hl",
            "city": "Webster",
            "state": "NY",
            "country_code": "US",
            "postal_code": "145809660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "WEBSTER",
            "affiliation": "N",
            "address_1": "1555 Barrow Hl",
            "city": "Webster",
            "state": "NY",
            "country_code": "US",
            "postal_code": "145809660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erin Hendry
• Patricia Jean Hendy
• Arthur S Hengerer, MD
• William A Henion, M.D.
• Janelle M Hennard, NP
• Joseph D Hennig, MD
• Brooke Sarah Henninger, MD
• Courtney Elizabeth Henninger, FNP
• Monica J Henoch, MD
• Darlene Henri

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Rochester, NY
• Providers in Rochester, NY by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.