Individual provider Active NPI

Kathryn Henecke

  • Psychiatric/Mental Health Nurse Practitioner
  • Windsor, CO
National Provider Identifier
1598206435
Registry record updated Mar 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN.0992990-NP Issued in CO
Practice address
824 Elm St
Windsor, CO 80550-4738
Phone
(970) 218-2452
NPI assigned
Mar 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1617943 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.0992990-NP CO Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RXN.0102515-NP CO

Addresses

Primary practice location

824 Elm St
Windsor, CO 80550-4738

Mailing address

824 Elm St
Windsor, CO 80550-4738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170614000277 CO Practitioner - Nurse Practitioner 1759659840 Reassigns benefits to 1 organization
I20190711001387 KS Practitioner - Nurse Practitioner 1759659840 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1617943COMDRegistered Nurse
APN.0992990-NPCOMDPsychiatric/Mental Health Nurse Practitioner
RXN.0102515-NPCOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Via Christi Hospitals Wichita Inc. CurrentSince Jul 1, 2019 Accepting new patients
North Range Behavioral Health CurrentSince Aug 21, 2017 Accepting new patients
Poudre Valley Health Care Inc. Current Accepting new patients
Poudre Valley Health Care Inc CurrentSince May 18, 2017 Accepting new patients
Ascension Medical Group Via Christi, PA CurrentSince Jul 1, 2019 Accepting new patients
Ascension Medical Group Via Christi, PA CurrentSince Jul 1, 2019 Accepting new patients
Poudre Valley Health Care, Inc CurrentSince May 18, 2017 Accepting new patients
North Range Behavioral Health CurrentSince Aug 21, 2017 Accepting new patients
Ascension Via Christi Hospitals Wichita Inc. CurrentSince Jul 1, 2019 Accepting new patients
North Range Behavioral Health Current Accepting new patients
North Range Behavioral Health Past Accepting new patients

Locations

1025 Pennock Pl
Fort Collins, CO 80524
Phone (970) 495-8800

4601 Corbett Dr
Fort Collins, CO 80528
Phone (970) 207-4800

1140 M St
Greeley, CO 80631
Phone (970) 313-1173

1407 8th Ave
Greeley, CO 80631
Phone (970) 347-2121

1300 N 17th Ave
Greeley, CO 80631
Phone (970) 475-6016

1100 N Saint Francis Ave
Fl 4
Wichita, KS 67214
Phone (316) 268-8080

3311 E Murdock St
Wichita, KS 67208
Phone (316) 689-9107

929 N Saint Francis Ave
Wichita, KS 67214
Phone (316) 291-4396

3600 E Harry St
Wichita, KS 67218
Phone (316) 268-5426

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20807/brand/4/csg/1/fhir/r4

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1489190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489190400000",
    "number": "1598206435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 ELM ST",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805504738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 ELM ST",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805504738",
            "telephone_number": "970-218-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENECKE",
        "first_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-11",
        "last_updated": "2017-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "1617943",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0992990-NP",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "RXN.0102515-NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CO

Sources for this page

Verify at the official NPI Registry.