Individual provider Active NPI

Cammie Henry, R.N.

  • Registered Nurse
  • Kirkwood, MO
National Provider Identifier
1629445358
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
2004022521 Issued in MO
Practice address
18 Provincial CT
Kirkwood, MO 63122-1503
Phone
(314) 517-0666
NPI assigned
Aug 28, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2004022521 MO Primary

Addresses

Primary practice location

18 Provincial CT
Kirkwood, MO 63122-1503

Mailing address

18 Provincial CT
Kirkwood, MO 63122-1503
Phone (314) 517-0666

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2004022521MOMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1629445358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 PROVINCIAL CT",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631221503",
            "telephone_number": "314-517-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 PROVINCIAL CT",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631221503",
            "telephone_number": "314-517-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "CAMMIE",
        "name_prefix": "Mr.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-28",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2004022521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; 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.