Individual provider Active NPI

Holger Hennig, MD

  • Anesthesiology Physician
  • Springfield, OR
National Provider Identifier
1619961398
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD151763 Issued in OR
Practice address
3333 Riverbend Dr
Springfield, OR 97477-8800
Phone
(541) 222-3154
Fax
(541) 222-3359
NPI assigned
Sep 8, 2005
Last updated
Apr 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD60726694 WA
Anesthesiology Physician 207L00000X MD151763 OR Primary
Anesthesiology Physician 207L00000X 4739026-1205 UT

Addresses

Primary practice location

3333 Riverbend Dr
Springfield, OR 97477-8800

Mailing address

PO Box 7247
Springfield, OR 97475-0011
Phone (541) 686-9551

Other practice location 1

10630 SE 258th Pl
Damascus, OR 97089-6316
Phone (503) 482-5106

Other practice location 2

800 W 5th Ave
Spokane, WA 99204-2803
Phone (509) 458-5800

Other identifiers 4

IdentifierTypeStateIssuer
500624959MedicaidOR
1619961398MedicaidWA
D3869MedicaidUT
47390261201001OtherUTBXBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101022000459 OR Practitioner - Anesthesiology 8426020280 Reassigns benefits to 4 organizations
I20170406003191 WA Practitioner - Anesthesiology 8426020280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Anesthesia Physicians PCGroup PAC ID 3274420138, 93 clinicians

Practice addresses (Care Compare)

3333 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-2300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD151763ORMDAnesthesiology Physician
4739026-1205UTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Anesthesiology Group PC Anesthesiology CurrentSince Jul 26, 2010 Accepting new patients
Anesthesia Associates Northwest LLC Anesthesiology CurrentSince Apr 15, 2015 Accepting new patients
Oregon Pain Management LLC Anesthesiology CurrentSince Dec 6, 2020 Accepting new patients
Northwest Anesthesia Physicians PC Anesthesiology CurrentSince Feb 1, 2021 Accepting new patients
Anesthesia Associates, PS Anesthesiology CurrentSince Feb 25, 2017 Accepting new patients
Omega Interventional Pain PLLC Past Accepting new patients
Lifetree Medical Inc Anesthesiology Past Accepting new patients

Locations

120 NW 14th Ave
Ste 200
Portland, OR 97209
Phone (503) 771-1883

707 SW Washington St
Ste 700
Portland, OR 97205

1445 State St
Salem, OR 97301
Phone (503) 315-7338

2480 Liberty St NE
Ste 180
Salem, OR 97301
Phone (503) 371-1010

1460 G St
Springfield, OR 97477
Phone (541) 431-0665

3333 Riverbend Dr
Springfield, OR 97477
Phone (541) 222-3154

800 W 5th Ave
Spokane, WA 99204
Phone (509) 458-5800

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1619961398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7247",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974750011",
            "telephone_number": "541-686-9551",
            "fax_number": "541-687-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 RIVERBEND DR",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778800",
            "telephone_number": "541-222-3154",
            "fax_number": "541-222-3359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10630 SE 258th Pl",
            "address_purpose": "LOCATION",
            "city": "Damascus",
            "state": "OR",
            "postal_code": "970896316",
            "country_code": "US",
            "telephone_number": "503-482-5106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 W 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992042803",
            "country_code": "US",
            "telephone_number": "509-458-5800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNIG",
        "first_name": "HOLGER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD60726694",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD151763",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "4739026-1205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500624959",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619961398",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D3869",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BXBS",
            "identifier": "47390261201001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.