Andrew Anthony Henneberg, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

M-9485 Issued in ID

Practice address

980 W Ironwood Dr
Suite 201
Coeur D Alene, ID 83814

Phone

(208) 765-4888

Fax

(208) 667-8618

NPI assigned

Jul 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

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 1

Specialty

Obstetrics/Gynecology

Education

Loma Linda University School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coeur Obstetrics and Gynecology PLLCGroup PAC ID 1951306844, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ahenneberg624166@direct.multicare.org
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72467
• Direct secure messaging: andrew.henneberg@coeurobgyn.directbygreenway.com

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.

• Coeur Obstetrics and Gynecology, PLLC

  • Specialist
  • Coeur D Alene, ID
  • NPI 1730280744

  ID, Specialist

  Medicare reassignment Care Compare group NPD Authorized official

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

• Kootenai Health, Inc.

  • General Acute Care Hospital
  • Coeur D Alene, ID
  • NPI 1992798409

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1689603847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 W IRONWOOD DR",
            "address_2": "SUITE 201",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-765-4888",
            "fax_number": "208-667-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 W IRONWOOD DR",
            "address_2": "SUITE 201",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-765-4888",
            "fax_number": "208-667-8618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "980 W IRONWOOD DR",
            "address_2": "SUITE 304",
            "address_purpose": "LOCATION",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "country_code": "US",
            "telephone_number": "208-765-4888",
            "fax_number": "208-667-8618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNEBERG",
        "first_name": "ANDREW",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ID",
            "license": "M-9485",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "M-9485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807438700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alissa Mae Akers Helvik, ARNP
• Hemisphere Health PLLC
• Daniel Matthew Henbest, MD
• Melissa Marie Henbest, LCPC
• Amy Lynnette Hendricks
• Roy Randel Henneberg, MD
• Charlotte Hennig
• Susan Helen Hennige, LCSW
• Robert Joseph Henninger, M.ED. LCPC
• Sheena Marie Henry, M.D.

• All providers in Coeur D Alene, ID
• Obstetrics & Gynecology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.

Verify at the official NPI Registry.