Active NPI
Katheryn Louise Henninger, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Newport, OR
National Provider Identifier
1497842710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 087000310N6
- Practice address
- 51 SW Lee St
Newport, OR 97365-3823 - Phone
- (541) 574-5960
- Fax
- (844) 760-0526
- NPI assigned
- Oct 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 087000310N6 | OR | Primary |
Addresses
Primary practice location
51 SW Lee St
Newport, OR 97365-3823
Mailing address
36 SW Nye St
Newport, OR 97365-3821
Phone (541) 265-0445
Other practice location 1
3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964
Phone (503) 220-8262 ext. 57726
Other practice location 2
18650 NW Cornell Rd Ste 220
Hillsboro, OR 97124-9212
Phone (503) 848-5861
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500742691 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620864000000",
"number": "1497842710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 SW NYE ST",
"city": "NEWPORT",
"state": "OR",
"postal_code": "973653821",
"telephone_number": "541-265-0445",
"fax_number": "844-760-0526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 SW LEE ST",
"city": "NEWPORT",
"state": "OR",
"postal_code": "973653823",
"telephone_number": "541-574-5960",
"fax_number": "844-760-0526"
}
],
"practiceLocations": [
{
"address_1": "3710 SW US Veterans Hospital Rd",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972392964",
"country_code": "US",
"telephone_number": "503-220-8262 x57726",
"fax_number": "503-721-1047",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "18650 NW Cornell Rd Ste 220",
"address_purpose": "LOCATION",
"city": "Hillsboro",
"state": "OR",
"postal_code": "971249212",
"country_code": "US",
"telephone_number": "503-848-5861",
"fax_number": "503-848-5863",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HENNINGER",
"first_name": "KATHERYN",
"middle_name": "LOUISE",
"name_prefix": "Ms.",
"credential": "PMHNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-06",
"last_updated": "2021-05-13",
"certification_date": "2021-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": "087000310N6",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500742691",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newport, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.