Elaine Ruth Henson, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

16376 Issued in CA

Practice address

15333 N Pima Rd Ste 305
Scottsdale, AZ 85260-2717

Phone

(887) 318-9948

NPI assigned

Aug 9, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Mrs. Elaine Ruth Brosious-Henson Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Sharp Rees-Stealy Medical Group, Inc

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1285616177

  Nurse Practitioner

  Medicare reassignment NPD
• Womens Medical Health Center Inc

  • Nurse Practitioner
  • Lake Havasu City, AZ
  • NPI 1811952047
  NPD (past) Authorized official
• Sharp Rees-Stealy Medical Group, Inc

  • Optometrist
  • San Diego, CA
  • NPI 1063172351
  NPD
• Revolutionary Services LLC

  • Multi-Specialty Clinic/Center
  • Fort Mohave, AZ
  • NPI 1518082122
  NPD (past)
• Eisenhower Medical Center

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  NPD (past)
• Integrative Womens Care PC

  • Obstetrics & Gynecology Physician
  • Palo Alto, CA
  • NPI 1972266732
  NPD (past)

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1306847686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4264 FEATHER AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175531",
            "telephone_number": "928-208-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15333 N PIMA RD STE 305",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602717",
            "telephone_number": "887-318-9948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "429 FORTH AVENUE",
            "address_2": "7 TH FLOOR",
            "address_purpose": "LOCATION",
            "city": "PITTSBURG",
            "state": "PA",
            "postal_code": "15219",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "445 S Figueroa St Fl 31",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900711602",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENSON",
        "first_name": "ELAINE",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AZNP54",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "16376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "500000021",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "333253",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0153580",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELAINE",
            "last_name": "BROSIOUS-HENSON",
            "middle_name": "RUTH",
            "prefix": "MRS.",
            "credential": "ANP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kyle Joseph Henry, MD
• Meagan Henry
• Gerri Hensel, RPH
• John Andrew Hensing, MD
• Therese Giedraitis Hensler, LCSW
• Gretchen Kathleen Henson, DDS
• Laura Knoll Henson, M.D.
• William G Heob, M.S.CCC-A
• Hunter Herb
• Steven Eric Herber, MD

• Adult Health Nurse Practitioner in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Adult Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.