Individual provider Active NPI

Amanda Gail Henry, APRN-CNS

  • Gerontology Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1174202485
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
214262 Issued in OK
Practice address
4120 W Memorial Rd Ste 300
Oklahoma City, OK 73120-9322
Phone
(405) 302-2661
Fax
(405) 302-2670
NPI assigned
Jul 13, 2023
Last updated
Apr 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 214262 OK Primary
Adult Health Clinical Nurse Specialist 364SA2200X 214262 OK

Addresses

Primary practice location

4120 W Memorial Rd Ste 300
Oklahoma City, OK 73120-9322

Mailing address

PO Box 776084
Chicago, IL 60677-6084
Phone (405) 290-8652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231024003349 OK Practitioner - Nurse Practitioner 7911353115 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

4120 W Memorial Rd
Suite 205
Oklahoma City, OK 73120-9322
Phone (405) 749-4205

825 NE 10TH St
Oklahoma City, OK 73104-5417
Phone (405) 271-4700

900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
214262OKMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities CurrentSince Jan 27, 2026 Accepting new patients
Ou Health Partners, Inc CurrentSince Oct 14, 2024 Accepting new patients
Ou Health Partners, Inc CurrentSince Oct 14, 2024 Accepting new patients
Norman Regional Providers Specialty Care CurrentSince Sep 11, 2023 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Ou Medicine Inc. Past Accepting new patients

Locations

3300 Healthplex Pkwy
Norman, OK 73072
Phone (405) 329-4102

901 N Porter Ave
Norman, OK 73071
Phone (405) 307-1500

4120 W Memorial Rd
Ste 205
Oklahoma City, OK 73120
Phone (405) 749-2992

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

825 NE 10th St
Ste 5B
Oklahoma City, OK 73104
Phone (405) 271-3635

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1174202485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084",
            "telephone_number": "405-290-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 W MEMORIAL RD STE 300",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209322",
            "telephone_number": "405-302-2661",
            "fax_number": "405-302-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "AMANDA",
        "middle_name": "GAIL",
        "credential": "APRN-CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-13",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OK",
            "license": "214262",
            "primary": true
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "OK",
            "license": "214262",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.