Cindy A Henley, ADVANCE PRACTICE NUR

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

209-002243 Issued in IL

Practice address

1909 W Coolidge Ave
Marion, IL 62959

Phone

(618) 997-5677

Fax

(618) 997-3627

NPI assigned

Sep 20, 2006

Last updated

Oct 8, 2018By the provider in NPPES

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

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Si Medical, Inc.

  • Primary Care Nurse Practitioner
  • Marion, IL
  • NPI 1659632602
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1558468975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 193",
            "city": "GOREVILLE",
            "state": "IL",
            "postal_code": "629390193",
            "telephone_number": "618-995-9391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 W COOLIDGE AVE",
            "city": "MARION",
            "state": "IL",
            "postal_code": "62959",
            "telephone_number": "618-997-5677",
            "fax_number": "618-997-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENLEY",
        "first_name": "CINDY",
        "middle_name": "A",
        "credential": "ADVANCE PRACTICE NUR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209-002243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE NURSE",
            "identifier": "209-002243",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhonda Raye Heatherly, APN, FNP
• Charles K Hees, PH.D.
• Jill Marie Hefner, RN
• Jamie Heibner
• Roberta Heldenbrand
• Verlinda Henshaw, OTD
• Elizabeth Maurine Hensley, M.S.
• Dustin Henson
• Elizabeth Ann Henson, RN
• Leslie Skyles Hentschel, MSW, LSW

• Gerontology Nurse Practitioner in Marion, IL
• Providers in Marion, IL by specialty
• Gerontology Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.