Individual provider Active NPI

Julie Henson

  • Family Medicine Physician
  • Dixon, IL
National Provider Identifier
1477912731
Registry record updated Oct 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36179721 Issued in IL
Practice address
1321 N Galena Ave
Dixon, IL 61021-1009
Phone
(815) 284-1600
NPI assigned
Feb 15, 2016
Last updated
Oct 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36179721 IL Primary
Family Medicine Physician 207Q00000X 2022044990 MO
Family Medicine Physician 207Q00000X 1679 NE

Addresses

Primary practice location

1321 N Galena Ave
Dixon, IL 61021-1009

Mailing address

101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 625-4790

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230720002881 MO Practitioner - Family Practice 4486947900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citizens Memorial HealthcareGroup PAC ID 4183528169, 144 clinicians

Practice addresses (Care Compare)

Bolivar, MO 65613
Phone (417) 328-6631

1125 N Butterfield Rd
CMH Dermatology
Bolivar, MO 65613-1056
Phone (417) 328-4500

1155 W Parkview
Bolivar, MO 65613-7800

1155 W Parkview
2K CMH Rheumatology
Bolivar, MO 65613-8598
Phone (417) 328-7000

1155 W Parkview St
Bolivar, MO 65613-7800

1155 W Parkview St
Bolivar, MO 65613-8597

1155 W Parkview St
1C
Bolivar, MO 65613-8279
Phone (417) 326-7246

1155 W Parkview St
Suite 2J
Bolivar, MO 65613-8598
Phone (417) 328-7702

1160 W Parkview St
CMH Nephrology Clinic
Bolivar, MO 65613-8279
Phone (417) 328-7300

1245 N Butterfield Rd
Bolivar, MO 65613-3017

1500 N Oakland Ave
CMH Diabetes
Bolivar, MO 65613-3099
Phone (417) 328-6040

1501 N Oakland Ave
CMH Oncology Clinic
Bolivar, MO 65613-3020
Phone (417) 328-7200

2001 W Broadway St
Bolivar, MO 65613-1861

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1679NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Citizens Memorial Healthcare CurrentSince Jun 27, 2023 Accepting new patients
Citizens Memorial Healthcare Family Medicine CurrentSince Jun 27, 2023 Accepting new patients

Locations

1240 N Butterfield Rd
Bolivar, MO 65613
Phone (417) 326-6021

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792108800000",
    "number": "1477912731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MILLER RD",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811252",
            "telephone_number": "815-625-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 N GALENA AVE",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610211009",
            "telephone_number": "815-284-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "JULIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "36179721",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2022044990",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "1679",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

Verify at the official NPI Registry.