Raven K Henry, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1110816 Issued in TX

Practice address

310 W Alameda St
Iowa Park, TX 76367-1600

Phone

(940) 592-4141

NPI assigned

Feb 14, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Electra Hospital District

  • Family Nurse Practitioner
  • Electra, TX
  • NPI 1417051806

  Family, TX

  Medicare reassignment NPD
• Electra Hospital District

  • Critical Access Hospital
  • Electra, TX
  • NPI 1871583153

  TX

  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  TX

  Medicare reassignment NPD
• Electra Hospital District

  • Community/Retail Pharmacy
  • Electra, TX
  • NPI 1699867853
  NPD
• Electra Hospital District

  • Rural Health Clinic/Center
  • Iowa Park, TX
  • NPI 1346805348
  NPD (past)
• Electra Hospital District

  • Home Health Agency
  • Electra, TX
  • NPI 1417947706
  NPD (past)

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1497452007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 11TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014300",
            "telephone_number": "940-764-8312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W ALAMEDA ST",
            "city": "IOWA PARK",
            "state": "TX",
            "postal_code": "763671600",
            "telephone_number": "940-592-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "RAVEN",
        "middle_name": "K",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-14",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1110816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Kaye Harley, LBSW-IPR
• Veronica Dawn Harp, AGNP
• Hawk Pharmacy, Inc
• Health-E-Connections
• Brie Heaton, PNP
• Iowa Park Consolidated I.S.D
• Iowa Park Physical Therapy
• JKDB Enterprises LLC
• Kelly Lynn Jolly, RPH
• Sheena Kaufman

• All providers in Iowa Park, TX
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.