Individual provider Active NPI

Thomas John Henline, PA-C

  • Physician Assistant
  • Redding, CA
National Provider Identifier
1477137172
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
59787 Issued in CA
Practice address
2175 Rosaline Ave
Redding, CA 96001-2549
Phone
(253) 334-7061
NPI assigned
May 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 59787 CA Primary

Addresses

Primary practice location

2175 Rosaline Ave
Redding, CA 96001-2549

Mailing address

1903 Channel Rd E
Lake Tapps, WA 98391-6476
Phone (253) 334-7061

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20211014001453 CA Practitioner - Physician Assistant 5890193205 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardinal Emergency Providers Professional CorporationGroup PAC ID 3072005354, 28 clinicians

Practice addresses (Care Compare)

1100 Butte St
Redding, CA 96001-0852
Phone (530) 244-5400

Hospital & facility affiliations

  • Shasta Regional Medical Center Hospital, Redding, CA, CCN 050764
  • Mercy Medical Center Redding Hospital, Redding, CA, CCN 050280

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
59787CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince Oct 4, 2021 Accepting new patients
Cep America - California CurrentSince Sep 1, 2023 Accepting new patients
Cardinal Emergency Providers Professional Corporation Physician Assistant CurrentSince Dec 1, 2025 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1100 Butte St
Redding, CA 96001
Phone (530) 227-6361

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1620432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1477137172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 CHANNEL RD E",
            "city": "LAKE TAPPS",
            "state": "WA",
            "postal_code": "983916476",
            "telephone_number": "253-334-7061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 ROSALINE AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012549",
            "telephone_number": "253-334-7061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENLINE",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-08",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "59787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.