Sandra R. Henry, ANP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

104685 Issued in MO

Practice address

2900 Lemay Ferry Rd
Ste 104
Saint Louis, MO 63125-3900

Phone

(314) 525-1887

Fax

(314) 525-1868

NPI assigned

Oct 25, 2006

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

Other identifiers 1

Other names 1

• Sandra R. Gully Former name

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shenry996827@directc.mercy.net

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.

• Mercy Clinic East Communities

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1851335228
  Medicare reassignment Care Compare group NPD
• Mercy Clinic East Communities

  • Family Medicine Physician
  • Saint Louis, MO
  • NPI 1043574940
  NPD
• St. Anthony'S Physician Organization

  • Internal Medicine Physician
  • Kirkwood, MO
  • NPI 1487819512
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1831273515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 LEMAY FERRY RD",
            "address_2": "STE 104",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631253900",
            "telephone_number": "314-525-1887",
            "fax_number": "314-525-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 LEMAY FERRY RD",
            "address_2": "STE 104",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631253900",
            "telephone_number": "314-525-1887",
            "fax_number": "314-525-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "SANDRA",
        "middle_name": "R.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "104685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427423306",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "GULLY",
            "middle_name": "R.",
            "credential": "ANP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Dale Henry, APRN,BC
• Lynesa Janai Henry
• Mallory Lane Henry, PA
• Margo Thresa Henry
• Morgan Henry, M.S., PLBA.
• Theresa Marie Henry, OT
• Vinita A Henry, OD
• Drew Michael Hensel, MD
• Michael Hensiek
• Taylor Brianne Hensiek, DPT

• Gerontology Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Gerontology Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.