Active NPI
Dustin Henson
- Registered Nurse
- Marion, IL
National Provider Identifier
1407542632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 041364004
- Practice address
- 2401 W Main St
Marion, IL 62959-1188 - Phone
- (618) 997-5311
- NPI assigned
- Apr 12, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041364004 | IL | Primary |
Addresses
Primary practice location
2401 W Main St
Marion, IL 62959-1188
Mailing address
2401 W Main St
Marion, IL 62959-1188
Phone (618) 997-5311
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dustin.henson@va.gov | Direct |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041364004 | IL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681257600000",
"number": "1407542632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 W MAIN ST",
"city": "MARION",
"state": "IL",
"postal_code": "629591188",
"telephone_number": "618-997-5311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 W MAIN ST",
"city": "MARION",
"state": "IL",
"postal_code": "629591188",
"telephone_number": "618-997-5311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENSON",
"first_name": "DUSTIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-12",
"last_updated": "2023-04-12",
"certification_date": "2023-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041364004",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dustin.henson@va.gov",
"affiliation": "N",
"endpointDescription": "Secure government email",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2401 W Main St",
"city": "Marion",
"state": "IL",
"country_code": "US",
"postal_code": "629591188",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Marion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.