Individual provider Active NPI

Jessica Mae Henning, DPT

  • Physical Therapist
  • Carmel, IN
National Provider Identifier
1629400585
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05011201A Issued in IN
Practice address
9919 Towne Rd
Carmel, IN 46032-8260
Phone
(317) 872-4166
NPI assigned
Aug 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05011201A IN Primary

Addresses

Primary practice location

9919 Towne Rd
Carmel, IN 46032-8260

Mailing address

3705 Sumter Way
Carmel, IN 46032-8639
Phone (219) 776-2043

Other practice location 1

11360 Broadway
Crown Point, IN 46307-7197
Phone (219) 662-8929

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
05011201AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Children'S Theraplay Foundation, Inc. Physical Therapist PastSince Dec 13, 2022 Accepting new patients

Organizations & group practices 1

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": "1375401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1629400585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 SUMTER WAY",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328639",
            "telephone_number": "219-776-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9919 TOWNE RD",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328260",
            "telephone_number": "317-872-4166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11360 Broadway",
            "address_purpose": "LOCATION",
            "city": "Crown Point",
            "state": "IN",
            "postal_code": "463077197",
            "country_code": "US",
            "telephone_number": "219-662-8929",
            "fax_number": "219-662-7814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNING",
        "first_name": "JESSICA",
        "middle_name": "MAE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-02",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05011201A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.