NPIMap

Individual provider Active NPI

Sunny P Henrion, PA-C

  • Physician Assistant
  • Loveland, CO
National Provider Identifier
1174851331
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-2943 Issued in CO
Practice address
302 3Rd St SE
Suite 150
Loveland, CO 80537-6419
Phone
(970) 669-4855
Fax
(970) 669-7389
NPI assigned
Nov 30, 2009
Last updated
Feb 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-2943 CO Primary

Addresses

Primary practice location

302 3Rd St SE
Suite 150
Loveland, CO 80537-6419

Mailing address

2930 11TH Ave
Evans, CO 80620-1011
Phone (970) 353-9403

Other identifiers 1

IdentifierTypeStateIssuer
71858555MedicaidCO

Other names 1

  • Sang Hee Park Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100609000815 CO Practitioner - Physician Assistant 4486784964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

1605 Foxtrail Dr
Unit 100
Loveland, CO 80538-9361
Phone (970) 495-0506

3744 S Timberline Rd
Suite 102 Uchealth Paint Managemt Clin Ft C
Fort Collins, CO 80525-4334
Phone (970) 495-0506

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

730 14TH St SW
Suite 200
Loveland, CO 80537-6349
Phone (970) 663-0815

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2943COMDOptometrist
PA-2943COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jul 1, 2020 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jul 1, 2020 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

3744 S Timberline Rd
Ste 102
Fort Collins, CO 80525
Phone 970495050613

1605 Foxtrail Dr
Unit 100
Loveland, CO 80538
Phone (970) 674-6514

1605 Foxtrail Dr
Loveland, CO 80538
Phone (970) 672-8875

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2403

2500 Rocky Mountain Ave
Ste 2200
Loveland, CO 80538
Phone (970) 203-7250

Organizations & group practices 2

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 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486339200000",
    "number": "1174851331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 11TH AVE",
            "city": "EVANS",
            "state": "CO",
            "postal_code": "806201011",
            "telephone_number": "970-353-9403",
            "fax_number": "970-350-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 3RD ST SE",
            "address_2": "SUITE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805376419",
            "telephone_number": "970-669-4855",
            "fax_number": "970-669-7389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRION",
        "first_name": "SUNNY",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-30",
        "last_updated": "2017-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA-2943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71858555",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANG",
            "last_name": "PARK",
            "middle_name": "HEE",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.