Individual provider Active NPI

Renee M. Henigan, MD

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1194907683
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
N5101 Issued in TX
Practice address
1434 E Sonterra Blvd Ste 109
San Antonio, TX 78258-4972
Phone
(210) 479-3000
Fax
(210) 479-3016
NPI assigned
Nov 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X N5101 TX Primary

Addresses

Primary practice location

1434 E Sonterra Blvd Ste 109
San Antonio, TX 78258-4972

Mailing address

333 N Santa Rosa St
Suite D4023
San Antonio, TX 78207-3108
Phone (469) 282-2711

Other identifiers 5

IdentifierTypeStateIssuer
218136404MedicaidTX
173321401OtherTXGROUP TPI
1265475891OtherTXGROUP NPI NUMBER
173321402OtherTXGROUP TPI NUMBER-EPSDT
218136401MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20101209001193 TX Practitioner - Pediatric Medicine 4385831809 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N5101TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Jan 1, 2022 Accepting new patients
Christus Trinity Clinic Texas Pediatrics CurrentSince Jan 1, 2022 Accepting new patients

Locations

1434 E Sonterra Blvd
Ste 109
San Antonio, TX 78258
Phone (210) 479-3000

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: rhenigan282946@christushealth.direct-ci.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1194907683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SANTA ROSA ST",
            "address_2": "SUITE D4023",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073108",
            "telephone_number": "469-282-2711",
            "fax_number": "469-282-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1434 E SONTERRA BLVD STE 109",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584972",
            "telephone_number": "210-479-3000",
            "fax_number": "210-479-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENIGAN",
        "first_name": "RENEE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-27",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N5101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218136404",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TPI",
            "identifier": "173321401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI NUMBER",
            "identifier": "1265475891",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TPI NUMBER-EPSDT",
            "identifier": "173321402",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218136401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.