NPIMap

Individual provider Active NPI

Theodore Jeffery Henning, MD

  • Diagnostic Radiology Physician
  • Little Rock, AR
National Provider Identifier
1477542793
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
E0829 Issued in AR
Practice address
500 S University Ave
Suite 101
Little Rock, AR 72205-5302
Phone
(501) 664-3914
Fax
(501) 664-5246
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X E0829 AR Primary

Addresses

Primary practice location

500 S University Ave
Suite 101
Little Rock, AR 72205-5302

Mailing address

500 S University Ave
Suite 600
Little Rock, AR 72205-5302
Phone (501) 664-3914

Other identifiers 1

IdentifierTypeStateIssuer
136011001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040421001760 AR Practitioner - Diagnostic Radiology 6406842814 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Arkansas College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHI St Vincent Medical Group Hot SpringsGroup PAC ID 3971673716, 184 clinicians
St Vincent Medical GroupGroup PAC ID 5698758803, 237 clinicians
Radiology Associates PAGroup PAC ID 7517953912, 103 clinicians

Practice addresses (Care Compare)

1 Mercy LN
Suite 404
Hot Springs, AR 71913-6441
Phone (501) 609-2222

2 Saint Vincent Cir
Little Rock, AR 72205-5423
Phone (501) 552-4666

500 S University Ave
Suite 101
Little Rock, AR 72205-5399
Phone (501) 664-3914

Hospital & facility affiliations

  • CHI St. Vincent Hospital Hot Springs Hospital, Hot Springs, AR, CCN 040026
  • South Arkansas Regional Hospital LLC Hospital, El Dorado, AR, CCN 040088
  • Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029
  • Jefferson Regional Medical Center Hospital, Pine Bluff, AR, CCN 040071
  • Arkansas Heart Hospital, LLC Hospital, Little Rock, AR, CCN 040134

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E0829ARMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group Diagnostic Radiology CurrentSince Jan 1, 2011 Accepting new patients
CHI St. Vincent Medical Group Hot Springs CurrentSince Jun 1, 2025 Accepting new patients
Radiology Associates PA Diagnostic Radiology CurrentSince Feb 1, 2004 Accepting new patients
Pinnacle Radiology PLLC Diagnostic Radiology PastSince Oct 25, 2020 Accepting new patients

Locations

1 Mercy Ln
Ste 301
Hot Springs, AR 71913
Phone (501) 622-6556

1 Mercy Ln
Ste 404
Hot Springs National Park, AR 71913
Phone (501) 321-1026

1 Mercy Ln
Ste 201
Hot Springs National Park, AR 71913
Phone (501) 321-2229

16221 Saint Vincent Way
Little Rock, AR 72223
Phone (501) 221-0888

500 S University Ave
Ste 101
Little Rock, AR 72205
Phone (501) 686-2688

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

500 S University Ave
Ste 600
Little Rock, AR 72205
Phone (501) 686-2688

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.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1477542793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE",
            "address_2": "SUITE 600",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055302",
            "telephone_number": "501-664-3914",
            "fax_number": "501-664-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S UNIVERSITY AVE",
            "address_2": "SUITE 101",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055302",
            "telephone_number": "501-664-3914",
            "fax_number": "501-664-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNING",
        "first_name": "THEODORE",
        "middle_name": "JEFFERY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "E0829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136011001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.