Active NPI
Paula Henry
- Durable Medical Equipment & Medical Supplies
- Mariposa, CA
National Provider Identifier
1730105636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 100458
- Practice address
- 5034 Coakley Circle
Mariposa, CA 95338 - Phone
- (209) 742-6224
- Fax
- (209) 966-7848
- NPI assigned
- Jul 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 100458 | CA | Primary |
Addresses
Primary practice location
5034 Coakley Circle
Mariposa, CA 95338
Mailing address
PO Box 1913
Mariposa, CA 95338-1913
Phone (209) 742-6162
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DME00572F | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 100458 | CA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378166400000",
"number": "1730105636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1913",
"city": "MARIPOSA",
"state": "CA",
"postal_code": "953381913",
"telephone_number": "209-742-6162",
"fax_number": "209-742-6163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5034 COAKLEY CIRCLE",
"city": "MARIPOSA",
"state": "CA",
"postal_code": "95338",
"telephone_number": "209-742-6224",
"fax_number": "209-966-7848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRY",
"first_name": "PAULA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2013-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "CA",
"license": "100458",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DME00572F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mariposa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.