Kyle Joseph Henneberry, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD00047394 Issued in WA

Practice address

16040 NE 153Rd St
Woodinville, WA 98072-8903

Phone

(208) 416-2932

Fax

(855) 673-9190

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Direct Radiology PLLC

  • Diagnostic Radiology Physician
  • Bothell, WA
  • NPI 1144572173
  Medicare reassignment NPD Authorized official
• Columbus Radiology Physicians LLC

  • Diagnostic Radiology Physician
  • Columbus, IN
  • NPI 1467964718

  WA

  Medicare reassignment NPD
• Enloe Medical Center

  • Surgery Physician
  • Chico, CA
  • NPI 1477975613

  WA

  Medicare reassignment NPD
• Jason L Hwang MD Inc

  • Diagnostic Radiology Physician
  • Sonora, CA
  • NPI 1811486616

  WA

  Medicare reassignment NPD
• Oroville Hospital

  • General Acute Care Hospital
  • Oroville, CA
  • NPI 1710372909

  WA

  Medicare reassignment NPD
• Radiology Alliance PC

  • Diagnostic Radiology Physician
  • Nashville, TN
  • NPI 1861478489

  WA

  Medicare reassignment NPD
• Tennessee Valley Radiology LLC

  • Diagnostic Radiology Physician
  • Sweetwater, TN
  • NPI 1356367551

  WA

  Medicare reassignment NPD
• Acadiana Radiology Group

  • Diagnostic Radiology Physician
  • Lafayette, LA
  • NPI 1649422726
  NPD
• Enloe Medical Center

  • Community/Retail Pharmacy
  • Chico, CA
  • NPI 1912949538
  NPD
• High Tech Imaging Center Inc

  • Magnetic Resonance Imaging Radiologic Technologist
  • Montgomery, AL
  • NPI 1588753297
  NPD
• Med Tech Imaging Center LLC

  • Radiology Clinic/Center
  • Prattville, AL
  • NPI 1639678550
  NPD
• Winnie Community Hospital, LLC

  • Radiology Clinic/Center
  • Beaumont, TX
  • NPI 1871965913
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1285723957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22100 BOTHELL EVERETT HWY",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980218431",
            "telephone_number": "208-416-2932",
            "fax_number": "855-673-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16040 NE 153RD ST",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980728903",
            "telephone_number": "208-416-2932",
            "fax_number": "855-673-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNEBERRY",
        "first_name": "KYLE",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00047394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Jean Heath, LMFTA
• Julianne M Hegeman, OTR
• Hailey Heishman, ND
• Tracy Lynn Hendershott, PT
• Jerry Lynn Henderson, PT
• Daniel Henriquez, RN
• Minerva Henson, L. AC., EAMP
• Cheryl Jean Herrin-Michehl, LMHC
• David Martin Hester Jr., LMHC, MHP
• Patricia A Higgins, LMP, RBT

• Diagnostic Radiology Physician in Woodinville, WA
• Providers in Woodinville, WA by specialty
• Diagnostic Radiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.