Individual provider Active NPI

Wednesday M Henry, NP

  • Family Nurse Practitioner
  • Rockport, TX
National Provider Identifier
1467434233
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP113678 Issued in TX
Practice address
1202 FM 3036
Rockport, TX 78382-7798
Phone
(361) 729-0133
Fax
(361) 729-0855
NPI assigned
Nov 17, 2005
Last updated
Jan 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 160666 AK
Family Nurse Practitioner 363LF0000X 643131 TX
Family Nurse Practitioner 363LF0000X AP113678 TX Primary

Addresses

Primary practice location

1202 FM 3036
Rockport, TX 78382-7798

Mailing address

1202 FM 3036
Rockport, TX 78382-7798
Phone (361) 729-0133

Other practice location 1

135 River North Blvd
Stephenville, TX 76401-1804
Phone (254) 965-2810

Other practice location 2

1100 W Reynosa Ave
DE Leon, TX 76444-1630
Phone (254) 893-5895

Other practice location 3

3804 Highway 377 S
Brownwood, TX 76801-5120
Phone (325) 643-5167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20051026000260 TX Practitioner - Nurse Practitioner 1759308125 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

1202 FM
Suite 3036
Rockport, TX 78382-7798
Phone (361) 729-0133

6157 NW Loop 410
124 Wellmed at Ingram Park
San Antonio, TX 78238-3302
Phone (210) 523-1411

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
160666AKMDNurse Practitioner
643131TXMDFamily Nurse Practitioner
AP113678TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince Jan 16, 2024 Accepting new patients
Wellmed Medical Group, P.a. CurrentSince Jan 16, 2024 Accepting new patients
Kennewick Public Hospital District Past Accepting new patients

Locations

1202 FM 3036
Rockport, TX 78382
Phone (361) 729-0133

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

Interoperability endpoints

  • Direct secure messaging: wednesday.henry@wellmed.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1467434233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 FM 3036",
            "city": "ROCKPORT",
            "state": "TX",
            "postal_code": "783827798",
            "telephone_number": "361-729-0133",
            "fax_number": "361-729-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 FM 3036",
            "city": "ROCKPORT",
            "state": "TX",
            "postal_code": "783827798",
            "telephone_number": "361-729-0133",
            "fax_number": "361-729-0855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 River North Blvd",
            "address_purpose": "LOCATION",
            "city": "Stephenville",
            "state": "TX",
            "postal_code": "764011804",
            "country_code": "US",
            "telephone_number": "254-965-2810",
            "fax_number": "866-247-6022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 W Reynosa Ave",
            "address_purpose": "LOCATION",
            "city": "DE Leon",
            "state": "TX",
            "postal_code": "764441630",
            "country_code": "US",
            "telephone_number": "254-893-5895",
            "fax_number": "866-247-6022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3804 Highway 377 S",
            "address_purpose": "LOCATION",
            "city": "Brownwood",
            "state": "TX",
            "postal_code": "768015120",
            "country_code": "US",
            "telephone_number": "325-643-5167",
            "fax_number": "325-641-1856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRY",
        "first_name": "WEDNESDAY",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AK",
            "license": "160666",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "643131",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP113678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockport, TX

Sources for this page

Verify at the official NPI Registry.