Individual provider Active NPI

Jannell Francine Henderson, MD

  • Diagnostic Radiology Physician
  • Edina, MN
National Provider Identifier
1225039167
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A78011 Issued in CA
Practice address
3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone
(952) 595-1301
Fax
(612) 294-4903
NPI assigned
Aug 2, 2005
Last updated
Dec 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD.202750 LA
Diagnostic Radiology Physician 2085R0202X A78011 CA Primary

Addresses

Primary practice location

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915

Mailing address

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone (952) 595-1301

Other names 1

  • Jannell Francine Manalo Diaz-Horsley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050615000507 CA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 7618911181 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Loma Linda University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians
Crouse Radiology Associates LLPGroup PAC ID 1850387648, 105 clinicians
Virtual Radiologic Professionals of California PAGroup PAC ID 7719989342, 55 clinicians

Practice addresses (Care Compare)

10263 Winecreek CT
San Diego, CA 92127-3728
Phone (952) 595-1100

3637 Kingsley St
San Diego, CA 92106-1107
Phone (315) 234-7600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A78011CAMDDiagnostic Radiology Physician
MD.202750LAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Diagnostic Radiology CurrentSince Oct 4, 2024 Accepting new patients
Crouse Radiology Associates LLP Diagnostic Radiology CurrentSince Jun 20, 2023 Accepting new patients
Regents of the University of California Diagnostic Radiology CurrentSince Oct 4, 2024 Accepting new patients
Advanced Berkshire Medical Imaging, PC Diagnostic Radiology CurrentSince Dec 1, 2025 Accepting new patients
Pontchartrain Diagnostic Imaging LLC Diagnostic Radiology CurrentSince May 12, 2019 Accepting new patients
Virtual Radiologic Professionals of California, P.a Diagnostic Radiology CurrentSince May 11, 2009 Accepting new patients
Cambridge Public Health Commission CurrentSince Feb 7, 2025 Accepting new patients
Computerized Diagnostic Imaging Center Past Accepting new patients
Hawthorne Radiology Associates Medical Group, Inc. Diagnostic Radiology Past Accepting new patients
Administrators of the Tulane Educational Fund Past Accepting new patients
Universal Radiology Consultants PC Diagnostic Radiology PastSince Aug 12, 2017 Accepting new patients
Riverside Radiology Medical Group Inc Diagnostic Radiology PastSince Nov 1, 2008 Accepting new patients
Alameda Health System Past Accepting new patients
Corwin Medical Group Inc Ipa Past Accepting new patients

Locations

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

10 Little Brook Rd
West Wareham, MA 02576

11995 Singletree Ln
Ste 500
Eden Prairie, MN 55344
Phone (952) 595-1143

3600 Minnesota Dr
Ste 800
Minneapolis, MN 55435
Phone (612) 595-1100

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 5

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1225039167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JANNELL",
        "middle_name": "FRANCINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "MD.202750",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A78011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANNELL FRANCINE",
            "last_name": "DIAZ-HORSLEY",
            "middle_name": "MANALO",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.