Individual provider Active NPI

Justin G Henne, FNP-C

  • Family Nurse Practitioner
  • Killeen, TX
National Provider Identifier
1235688755
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP132046 Issued in TX
Practice address
3400 E Central Texas Expy Ste 101
Killeen, TX 76543-7326
Phone
(254) 741-6641
NPI assigned
Sep 26, 2016
Last updated
Apr 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP132046 TX Primary

Addresses

Primary practice location

3400 E Central Texas Expy Ste 101
Killeen, TX 76543-7326

Mailing address

2000 S Mays St Ste 201
Round Rock, TX 78664-7580
Phone (512) 244-4272

Other practice location 1

607 W Lassater
Centerville, TX 75833-1959
Phone (903) 536-3687

Other identifiers 1

IdentifierTypeStateIssuer
39423502MedicaidTX

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170113000530 TX Practitioner - Nurse Practitioner 8628350386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mark Malone MD PAGroup PAC ID 2567369424, 102 clinicians

Practice addresses (Care Compare)

3400 E Central Texas Expy
Suite 101
Killeen, TX 76543-7326
Phone (254) 741-6641

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as individual
Quality
80.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP132046TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Malone MD PA CurrentSince Feb 27, 2022 Accepting new patients
Mark Malone MD PA CurrentSince Oct 31, 2016 Accepting new patients
Mark Malone, MD PA CurrentSince Oct 31, 2016 Accepting new patients

Locations

6000 S Mopac Expy
Ste 100
Austin, TX 78749

1106 College St
Ste C
Bastrop, TX 78602
Phone (512) 244-2895

3400 E Central Texas Expy
Ste 101
Killeen, TX 76543

2000 S Mays St
Ste 201
Round Rock, TX 78664
Phone (512) 492-3743

3500 Hillcrest Dr
Ste 1
Waco, TX 76708

Interoperability endpoints

  • Direct secure messaging: justin.henne.1@24201.direct.athenahealth.com

Organizations & group practices 3

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": "1474848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1235688755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S MAYS ST STE 201",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647580",
            "telephone_number": "512-244-4272",
            "fax_number": "979-260-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 E CENTRAL TEXAS EXPY STE 101",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765437326",
            "telephone_number": "254-741-6641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "607 W Lassater",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "TX",
            "postal_code": "758331959",
            "country_code": "US",
            "telephone_number": "903-536-3687",
            "fax_number": "903-536-7723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNE",
        "first_name": "JUSTIN",
        "middle_name": "G",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-26",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP132046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39423502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

Verify at the official NPI Registry.