Individual provider Active NPI

Androni Henry, M.D.

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1821389685
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036.132797 Issued in IL
Practice address
5645 W Addison St
Chicago, IL 60634-4403
Phone
(616) 560-7256
NPI assigned
Apr 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036.132797 IL Primary

Addresses

Primary practice location

5645 W Addison St
Chicago, IL 60634-4403

Mailing address

5645 W Addison St
Chicago, IL 60634-4403
Phone (616) 560-7256

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210923001774 MI Practitioner - Emergency Medicine 3072747674 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.132797ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Partners CurrentSince Oct 1, 2021 Accepting new patients
Grand River Emergency Medical Group PLC Emergency Medicine CurrentSince Mar 27, 2022 Accepting new patients
Mercy Health Partners Family Medicine CurrentSince Oct 1, 2021 Accepting new patients

Locations

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

71 Bevier St
Shelby, MI 49455
Phone (231) 861-2172

905 E Colby St
Whitehall, MI 49461
Phone (231) 672-8050

Interoperability endpoints

  • Direct secure messaging: ahenry1349471@direct.trinity-health.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.

NPI Registry JSON

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1821389685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5645 W ADDISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344403",
            "telephone_number": "616-560-7256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 W ADDISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344403",
            "telephone_number": "616-560-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "ANDRONI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-28",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.132797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.