Individual provider Active NPI

Joi Henry, DNP, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1174058564
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
309.018490 Issued in IL
Practice address
30 N Michigan Ave Ste 424
Chicago, IL 60602-3844
Phone
(312) 279-9981
Fax
(312) 279-9981
NPI assigned
Apr 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209.024578 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 309.018490 IL Primary

Addresses

Primary practice location

30 N Michigan Ave Ste 424
Chicago, IL 60602-3844

Mailing address

1506 E Roosevelt Rd
Wheaton, IL 60187-6806
Phone (630) 221-1400

Other identifiers 4

IdentifierTypeStateIssuer
309.018490OtherILCONTROLLED SUBSTANCE
0414499595OtherILRN
041.449595OtherILSTATE OF ILLINOIS
209.024578OtherILSTATE OF ILLINOIS

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address MINDBODYCOOP.JOIHENRY@147350.ADVANCEDMD-DIRECT.COM Health Information Exchange (HIE)
Direct Messaging Address MINDBODYCOOP.JOIHENRY@147350.ADVANCEDMD-DIRECT.COM Health Information Exchange (HIE) Mind Body Co-op

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
209.024578ILMDPsychiatric/Mental Health Nurse Practitioner
309.018490ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Body Co-Op Psychiatric/Mental Health CurrentSince Oct 1, 2022 Accepting new patients
Mind Body Co-Op Registered Nurse CurrentSince Feb 27, 2022 Accepting new patients
Stonybrook Center Past Accepting new patients
Stonybrook Center Inc. PastSince Aug 9, 2020 Accepting new patients

Locations

30 N Michigan Ave
Ste 424
Chicago, IL 60602
Phone (312) 279-9981

Interoperability endpoints

  • Direct secure messaging: mindbodycoop.joihenry@147350.advancedmd-direct.com

Organizations & group practices 4

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": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1174058564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 E ROOSEVELT RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601876806",
            "telephone_number": "630-221-1400",
            "fax_number": "630-221-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE STE 424",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023844",
            "telephone_number": "312-279-9981",
            "fax_number": "312-279-9981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "JOI",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-24",
        "last_updated": "2023-03-07",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.024578",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "309.018490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE",
            "identifier": "309.018490",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "0414499595",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS",
            "identifier": "041.449595",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS",
            "identifier": "209.024578",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MINDBODYCOOP.JOIHENRY@147350.ADVANCEDMD-DIRECT.COM",
            "affiliation": "N",
            "endpointDescription": "AMD",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "30 N Michigan Ave Ste 424",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606023844",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MINDBODYCOOP.JOIHENRY@147350.ADVANCEDMD-DIRECT.COM",
            "affiliation": "Y",
            "endpointDescription": "amd",
            "affiliationName": "Mind Body Co-op",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "30 N Michigan Ave Ste 424",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606023844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.