Individual provider Active NPI

Kathleen Ann Henry, APN/CNP

  • Family Nurse Practitioner
  • Orland Park, IL
National Provider Identifier
1497063135
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209007816 Issued in IL
Practice address
16513 106TH CT
Orland Park, IL 60467-4545
Phone
(708) 364-8100
Fax
(708) 364-1774
NPI assigned
Sep 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209007816 IL Primary

Addresses

Primary practice location

16513 106TH CT
Orland Park, IL 60467-4545

Mailing address

16513 106TH CT
Orland Park, IL 60467-4545
Phone (708) 364-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20110714000189 IL Practitioner - Nurse Practitioner 4486822616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Health Associates PCGroup PAC ID 0749254845, 9 clinicians

Practice addresses (Care Compare)

10300 Village Circle Dr
Palos Park, IL 60464-3541
Phone (708) 361-6091

16512 S 106TH CT
Orlando Park, IL 60467-4547
Phone (708) 364-8323

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Associates PC CurrentSince Jan 3, 2012 Accepting new patients

Locations

16513 106th Ct
Orland Park, IL 60467
Phone (708) 364-8100

16512 106th Ct
Orland Park, IL 60467
Phone (708) 364-8323

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGEBDA
  • Direct secure messaging: kathleen.henry@pha16512.eclinicaldirectplus.com

Organizations & group practices 1

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 6

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": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1497063135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16513 106TH CT",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674545",
            "telephone_number": "708-364-8100",
            "fax_number": "708-364-1774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16513 106TH CT",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604674545",
            "telephone_number": "708-364-8100",
            "fax_number": "708-364-1774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "APN/CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209007816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.