NPIMap

Individual provider Active NPI

Jodi Henrikson, MD

  • Obstetrics & Gynecology Physician
  • Great Bend, KS
National Provider Identifier
1821063652
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
04-30709 Issued in KS
Practice address
514 Cleveland St
Medical Pavilion
Great Bend, KS 67530-3562
Phone
(620) 792-2151
Fax
(620) 860-0305
NPI assigned
Feb 23, 2006
Last updated
May 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 04-30709 KS Primary

Addresses

Primary practice location

514 Cleveland St
Medical Pavilion
Great Bend, KS 67530-3562

Mailing address

514 Cleveland St
Medical Pavilion
Great Bend, KS 67530-3562
Phone (620) 792-2151

Other names 1

  • Mr. Jodi L Henrikson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040809000573 KS Practitioner - Obstetrics/Gynecology 5395717557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of North Dakota School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ukhs Great Bend LLCGroup PAC ID 5597016378, shared by 6 NPIs, 64 clinicians
Great Bend Regional Hospital LLCGroup PAC ID 2567374788, 4 clinicians

Practice addresses (Care Compare)

250 W 9TH St
Hoisington, KS 67544-1706
Phone (620) 792-8833

514 Cleveland St
Great Bend, KS 67530-3562

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-30709KSMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Valley Obstetrics & Gynecology, P.C. PastSince Mar 31, 2006 Accepting new patients
Northland Family Physicians LLC PastSince Sep 15, 2019 Accepting new patients
Ukhs Great Bend, LLC Past Accepting new patients
Aurora Urgent Care LLC PastSince Oct 1, 2006 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jhenrikson636965@direct.kuha.org
  • Direct secure messaging: jodi.henrickson@khindirect.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1821063652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 CLEVELAND ST",
            "address_2": "MEDICAL PAVILION",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303562",
            "telephone_number": "620-792-2151",
            "fax_number": "620-860-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 CLEVELAND ST",
            "address_2": "MEDICAL PAVILION",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303562",
            "telephone_number": "620-792-2151",
            "fax_number": "620-860-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIKSON",
        "first_name": "JODI",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KS",
            "license": "04-30709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODI",
            "last_name": "HENRIKSON",
            "middle_name": "L",
            "prefix": "MR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Great Bend, KS

Sources for this page

Verify at the official NPI Registry.