Individual provider Active NPI

Jenna Henry

  • Speech-Language Pathologist
  • Carlisle, PA
National Provider Identifier
1306470802
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL014993 Issued in PA
Practice address
417 Village Dr.
Suite 4
Carlisle, PA 17015
Phone
(717) 245-0610
NPI assigned
Feb 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL014993 PA Primary

Addresses

Primary practice location

417 Village Dr.
Suite 4
Carlisle, PA 17015

Mailing address

1849 Holly Dr
Camp Hill, PA 17011-7421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200820002414 PA Practitioner - Qualified Speech Language Pathologist 6800212853 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SL014993PAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
PHS Physical Therapy, LLC Speech-Language Pathologist CurrentSince Mar 16, 2020 Accepting new patients
PHS Physical Therapy, LLC CurrentSince Mar 16, 2020 Accepting new patients

Locations

417 Village Dr
Ste 4
Carlisle, PA 17015
Phone (717) 245-0610

1535 Highlands Dr
Ste 200
Lititz, PA 17543
Phone (717) 625-5731

6108 Carlisle Pike
#27041
Mechanicsburg, PA 17050
Phone (717) 591-9118

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1306470802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 HOLLY DR",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170117421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 VILLAGE DR.",
            "address_2": "SUITE 4",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "17015",
            "telephone_number": "717-245-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "JENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-24",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL014993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlisle, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.