Individual provider Active NPI

Katherine Margaret Theresa Henry, APRN, FNP-C

  • Primary Care Nurse Practitioner
  • Southlake, TX
National Provider Identifier
1255066635
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1067008 Issued in TX
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, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 Professional name

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

LicenseStateTypeSpecialty
1067008TXMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MC Healthcare PA CurrentSince Aug 1, 2022 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.

Verify at the official NPI Registry.