Camilla Henry, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DX3979 Issued in MD

Practice address

1237 S Val Vista Dr
Mesa, AZ 85204-6401

Phone

(480) 294-6543

Fax

(480) 294-6544

NPI assigned

Oct 15, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Michelle Berman Ms Rd Cde LLC

  • Registered Dietitian
  • Mesa, AZ
  • NPI 1750620134

  Dietitian, Registered

  NPD (past)
• St Regis Mohawk Tribe

  • Federally Qualified Health Center (FQHC)
  • Akwesasne, NY
  • NPI 1457344558
  NPD (past)

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

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1780347807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1564",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852111564",
            "telephone_number": "480-294-6543",
            "fax_number": "480-294-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 S VAL VISTA DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046401",
            "telephone_number": "480-294-6543",
            "fax_number": "480-294-6544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "CAMILLA",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-15",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "DX3979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Henning
• Melissa Erin Henning, PHARMD
• Matthew W. Henninger, PHD
• Waahidah Hennix
• Henry M Luedy MD PLLC
• Carmen Lynn Henry, FNP
• Lacey Henry
• Paula Henry, COTA
• Susan Jean Henry, BS, CLINICIAN I
• Wallace Henry Jr.

• Registered Dietitian in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Registered Dietitian in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.