Individual provider Active NPI

Colette Jane Henningsen, ARNP

  • Nurse Practitioner
  • Des Moines, IA
National Provider Identifier
1336413780
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
L-116577 Issued in IA
Practice address
1221 Pleasant St
Suite 200
Des Moines, IA 50309-1423
Phone
(515) 241-4019
Fax
(515) 241-4051
NPI assigned
Mar 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X L-116577 IA Primary

Addresses

Primary practice location

1221 Pleasant St
Suite 200
Des Moines, IA 50309-1423

Mailing address

1221 Pleasant St
Suite 200
Des Moines, IA 50309-1423
Phone (515) 241-4019

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20120515000257 IA Practitioner - Nurse Practitioner 1153584974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.56 of 100Reported as group
Quality
83.65
Promoting interoperability
78
Improvement activities
40
Cost
76.53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
L-116577IAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Iowa Hospital Corporation CurrentSince Apr 5, 2017 Accepting new patients
Central Iowa Hospital Corporation Current Accepting new patients
Central Iowa Hospital Corporation CurrentSince Apr 5, 2017 Accepting new patients
Neurointerventional Institute, P.a. Past Accepting new patients

Locations

1215 Pleasant St
Ste 600
Des Moines, IA 50309
Phone (515) 241-4646

1200 Pleasant St
Des Moines, IA 50309
Phone (515) 241-5926

1200 Pleasant St
Ste S228
Des Moines, IA 50309

1221 Pleasant St
Ste 200
Des Moines, IA 50309
Phone (515) 241-8221

1111 6th Ave
Des Moines, IA 50314
Phone (515) 247-3121

8101 Birchwood Ct
Unit R
Urbandale, IA 50131
Phone (515) 471-9363

Organizations & group practices 4

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": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1336413780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 PLEASANT ST",
            "address_2": "SUITE 200",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091423",
            "telephone_number": "515-241-4019",
            "fax_number": "515-241-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 PLEASANT ST",
            "address_2": "SUITE 200",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091423",
            "telephone_number": "515-241-4019",
            "fax_number": "515-241-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNINGSEN",
        "first_name": "COLETTE",
        "middle_name": "JANE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "L-116577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.