Active NPI
Jean Marie McHenry, PT
- Physical Therapist
- La Pine, OR
National Provider Identifier
1295710150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1428
- Practice address
- 51681 Huntington Rd
La Pine, OR 97739-9626 - Phone
- (541) 536-6122
- Fax
- (541) 536-6123
- NPI assigned
- Dec 13, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1428 | OR | Primary |
Addresses
Primary practice location
51681 Huntington Rd
La Pine, OR 97739-9626
Mailing address
PO Box 1888
La Pine, OR 97739-1888
Phone (541) 536-6122
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 024385 | Medicaid | OR | |
| 24385 | Medicaid | OR |
Other names 1
- Miss Jean Marie Canadas
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1428 | OR | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300320000000",
"number": "1295710150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1888",
"city": "LA PINE",
"state": "OR",
"postal_code": "977391888",
"telephone_number": "541-536-6122",
"fax_number": "541-536-6123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51681 HUNTINGTON RD",
"city": "LA PINE",
"state": "OR",
"postal_code": "977399626",
"telephone_number": "541-536-6122",
"fax_number": "541-536-6123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCHENRY",
"first_name": "JEAN",
"middle_name": "MARIE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-13",
"last_updated": "2011-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "1428",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "024385",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "24385",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JEAN",
"last_name": "CANADAS",
"middle_name": "MARIE",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in La Pine, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.