Mark W Henebry, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2009004293 Issued in MO

Practice address

108 Professional Parkway Dr.
Troy, MO 63379-2823

Phone

(636) 528-6080

Fax

(636) 528-3973

NPI assigned

Feb 3, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Rehabilitation Services LLCGroup PAC ID 8628344819, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Professional Rehabilitation Services, LLC

  • Physical Therapist
  • Troy, MO
  • NPI 1679671119
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1233619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1497993174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 PROFESSIONAL PARKWAY DR.",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633792823",
            "telephone_number": "636-528-6080",
            "fax_number": "636-528-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 PROFESSIONAL PARKWAY DR.",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633792823",
            "telephone_number": "636-528-6080",
            "fax_number": "636-528-3973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENEBRY",
        "first_name": "MARK",
        "middle_name": "W",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-03",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2009002205",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2009004293",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070017005",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda Hayden, PA-C
• Katherine Helm, PT, DPT
• Heather Annette Henke, RDH
• Marlana Dawn Henning, RDH
• Hewitt Orthodontics LLC
• Amanda Leann Hill, LCSW
• Sarah Marie Holcomb, LCSW

• Physical Therapist in Troy, MO
• Providers in Troy, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.