Active NPI
Katherine Margaret Theresa Henry, APRN, FNP-C
- Primary Care Nurse Practitioner
- Southlake, TX
National Provider Identifier
1255066635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 1067008
- Practice address
- 2010 E State Highway 114
Southlake, TX 76092-6514 - Phone
- (817) 893-9200
- Fax
- (817) 893-9300
- NPI assigned
- Jul 20, 2022
- Last updated
- Jan 24, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 1067008 | TX | Primary |
| Family Nurse Practitioner | 363LF0000X | 1067008 | TX |
Addresses
Primary practice location
2010 E State Highway 114
Southlake, TX 76092-6514
Mailing address
2010 E State Highway 114
Southlake, TX 76092-6514
Phone (817) 893-9200
Other practice location 1
3044 Old Denton Rd Ste 317
Carrollton, TX 75007-5017
Phone (972) 242-4440
Other names 1
- Katherine M Henry
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1067008 | TX | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MC Healthcare PA | Current | Accepting new patients |
Locations
3044 Old Denton Rd
Ste 317
Carrollton, TX 75007
Phone (972) 242-3361
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674518400000",
"number": "1255066635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2010 E STATE HIGHWAY 114",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926514",
"telephone_number": "817-893-9200",
"fax_number": "817-893-9300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2010 E STATE HIGHWAY 114",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926514",
"telephone_number": "817-893-9200",
"fax_number": "817-893-9300"
}
],
"practiceLocations": [
{
"address_1": "3044 Old Denton Rd Ste 317",
"address_purpose": "LOCATION",
"city": "Carrollton",
"state": "TX",
"postal_code": "750075017",
"country_code": "US",
"telephone_number": "972-242-4440",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HENRY",
"first_name": "KATHERINE",
"middle_name": "MARGARET THERESA",
"name_prefix": "Miss",
"credential": "APRN, FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-20",
"last_updated": "2023-01-24",
"certification_date": "2022-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "TX",
"license": "1067008",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "1067008",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATHERINE",
"last_name": "HENRY",
"middle_name": "M",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.