Individual provider Active NPI

Monica Zollner Henderson, DNP

  • Family Nurse Practitioner
  • Woodburn, OR
National Provider Identifier
1700229929
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201505318NP Issued in OR
Practice address
105 Arney Rd Ste 120
Woodburn, OR 97071-9472
Phone
(503) 814-4400
Fax
(503) 814-8659
NPI assigned
Apr 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201505318NP OR Primary

Addresses

Primary practice location

105 Arney Rd Ste 120
Woodburn, OR 97071-9472

Mailing address

105 Arney Rd Ste 120
Woodburn, OR 97071-9472
Phone (503) 814-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151109000331 OR Practitioner - Nurse Practitioner 6507176245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

105 Arney Rd
Suite 120
Woodburn, OR 97071-9472
Phone (503) 814-8640

Hospital & facility affiliations

  • Legacy Silverton Medical Center Hospital, Silverton, OR, CCN 380029
  • Salem Hospital Hospital, Salem, OR, CCN 380051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
201505318NPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health CurrentSince Jan 1, 2018 Accepting new patients
Salem Health CurrentSince Jan 1, 2018 Accepting new patients
Oregon State University Student Health Services Past Accepting new patients

Locations

1049 Edgewater St NW
#150
Salem, OR 97304
Phone (503) 814-3343

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

105 Arney Rd
Ste 120
Woodburn, OR 97071
Phone (503) 814-8640

Interoperability endpoints

  • Direct secure messaging: mhenderson23046@direct.salemhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1700229929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 ARNEY RD STE 120",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970719472",
            "telephone_number": "503-814-4400",
            "fax_number": "503-814-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 ARNEY RD STE 120",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "970719472",
            "telephone_number": "503-814-4400",
            "fax_number": "503-814-8659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "MONICA",
        "middle_name": "ZOLLNER",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-08",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201505318NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodburn, OR

Sources for this page

Verify at the official NPI Registry.