Randall S Henery, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D017983 Issued in OR

Practice address

217 Division Ave
Eugene, OR 97404-5429

Phone

(541) 688-3000

Fax

(541) 688-5368

NPI assigned

Aug 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Icco, LLC

  • Family Medicine Physician
  • Veneta, OR
  • NPI 1518990621
  NPD (past)
• Q Street Internists LLC

  • Internal Medicine Physician
  • Eugene, OR
  • NPI 1740483270
  NPD (past)

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1366459273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 DIVISION AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974045429",
            "telephone_number": "541-688-3000",
            "fax_number": "541-688-5368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 DIVISION AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974045429",
            "telephone_number": "541-688-3000",
            "fax_number": "541-688-5368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENERY",
        "first_name": "RANDALL",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "D017983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052014",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Marie Henderson, LPC
• Mary Angeline Hendrickson, LMHC, LPC, EMMHS
• Megan Hendrickson
• Sarah Shideler Hendrickson, M.D.
• Kaitlyn Anne Henecke
• Mary Elizabeth Henley
• Rebecca Elise Henlin
• Amanda Hennessey
• Patricia Ellen Henry-Schneider, MS, LPC
• Becca D Henry, PMHNP

• Internal Medicine Physician in Eugene, OR
• Providers in Eugene, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.