NPIMap

Individual provider Active NPI

Jennifer Chandra Henry, NP

  • Acute Care Nurse Practitioner
  • Soldotna, AK
National Provider Identifier
1215971387
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
902 Issued in AK
Practice address
250 Hospital PL
Soldotna, AK 99669-7559
Phone
(907) 714-4441
Fax
(907) 714-4699
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 902 AK Primary

Addresses

Primary practice location

250 Hospital PL
Soldotna, AK 99669-7559

Mailing address

250 Hospital PL
Soldotna, AK 99669-6999
Phone (907) 714-4444

Other identifiers 1

IdentifierTypeStateIssuer
1572915MedicaidAK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jhenry635734@ak.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20121221000164 AK Practitioner - Nurse Practitioner 8921068693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

250 Hospital PL
Soldotna, AK 99669-7559
Phone (907) 714-4515

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.44 of 100Reported as group
Quality
62.56
Promoting interoperability
81
Improvement activities
40
Cost
67.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Peninsula General Hospital Inc. Current Accepting new patients
Central Peninsula General Hospital, Inc CurrentSince Nov 4, 2012 Accepting new patients
Central Peninsula General Hospital, Inc CurrentSince Nov 4, 2012 Accepting new patients
North Star Medical Imaging PLLC Current Accepting new patients

Locations

10128 Kenai Spur Hwy
Kenai, AK 99611
Phone (907) 714-5740

250 Hospital Pl
Soldotna, AK 99669
Phone (907) 714-4404

Interoperability endpoints

  • Direct secure messaging: jhenry635734@ak.providencedirect.org

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.

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1215971387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 HOSPITAL PL",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996696999",
            "telephone_number": "907-714-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 HOSPITAL PL",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697559",
            "telephone_number": "907-714-4441",
            "fax_number": "907-714-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "JENNIFER",
        "middle_name": "CHANDRA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AK",
            "license": "902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1572915",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhenry635734@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "250 Hospital Pl",
            "city": "Soldotna",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996697559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

Verify at the official NPI Registry.