Individual provider Active NPI

Michael Richard Henning, ANP-C

  • Adult Health Nurse Practitioner
  • Chesterfield, VA
National Provider Identifier
1821281692
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0024167468 Issued in VA
Practice address
11901 Reedy Branch Rd
Chesterfield, VA 23838-4235
Phone
(804) 896-1499
Fax
(804) 590-1872
NPI assigned
Aug 24, 2007
Last updated
Mar 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0024167468 VA Primary

Addresses

Primary practice location

11901 Reedy Branch Rd
Chesterfield, VA 23838-4235

Mailing address

11901 Reedy Branch Rd
Chesterfield, VA 23838-4235
Phone (804) 896-1499

Other identifiers 1

IdentifierTypeStateIssuer
2014219829MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080709000322 VA Practitioner - Nurse Practitioner 8820160757 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024167468VAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Kidney Specialists CurrentSince Aug 1, 2017 Accepting new patients
Arthritis Specialists, LTD. PastSince Apr 28, 2000 Accepting new patients

Locations

3400 S Crater Rd
Ste B
Petersburg, VA 23805
Phone (804) 733-6960

201 E Ferrell St
South Hill, VA 23970
Phone (434) 647-3455

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1821281692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11901 REEDY BRANCH RD",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238384235",
            "telephone_number": "804-896-1499",
            "fax_number": "804-590-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11901 REEDY BRANCH RD",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238384235",
            "telephone_number": "804-896-1499",
            "fax_number": "804-590-1872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNING",
        "first_name": "MICHAEL",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-24",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024167468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2014219829",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, VA

Sources for this page

Verify at the official NPI Registry.