Active NPI
Michaela Henneberry, DNP, ARNP, FNP-C
- Family Nurse Practitioner
- Cedar Rapids, IA
National Provider Identifier
1639003809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A189940
- Practice address
- 1005 Blairs Ferry Rd NE Ste 30
Cedar Rapids, IA 52402-1292 - Phone
- (319) 289-7779
- Fax
- (319) 320-4644
- NPI assigned
- Jun 11, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A189940 | IA | Primary |
Addresses
Primary practice location
1005 Blairs Ferry Rd NE Ste 30
Cedar Rapids, IA 52402-1292
Mailing address
6800 Lake Dr Ste 285
West Des Moines, IA 50266-2544
Phone (515) 226-3116
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3912 Pine Wood Dr NE
Cedar Rapids, IA 52402-1752
6000 University Ave
Suite 350
West Des Moines, IA 50266-8241
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1781136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781136000000",
"number": "1639003809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 LAKE DR STE 285",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502662544",
"telephone_number": "515-226-3116",
"fax_number": "515-223-9341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 BLAIRS FERRY RD NE STE 30",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524021292",
"telephone_number": "319-289-7779",
"fax_number": "319-320-4644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENNEBERRY",
"first_name": "MICHAELA",
"credential": "DNP, ARNP, FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-06-11",
"last_updated": "2026-06-11",
"certification_date": "2026-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IA",
"license": "A189940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cedar Rapids, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.