Active NPI
Jenna Marie Henry
- Physical Therapist
- Red Oak, TX
National Provider Identifier
1831797166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1333771
- Practice address
- 205 S Main St Ste 1010
Red Oak, TX 75154-4664 - Phone
- (469) 917-0805
- NPI assigned
- Oct 9, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1333771 | TX | Primary |
Addresses
Primary practice location
205 S Main St Ste 1010
Red Oak, TX 75154-4664
Mailing address
8280 Meadow Rd Apt 6411
Dallas, TX 75231-3793
Phone (949) 294-8104
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1333771 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602201600000",
"number": "1831797166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8280 MEADOW RD APT 6411",
"city": "DALLAS",
"state": "TX",
"postal_code": "752313793",
"telephone_number": "949-294-8104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 S MAIN ST STE 1010",
"city": "RED OAK",
"state": "TX",
"postal_code": "751544664",
"telephone_number": "469-917-0805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRY",
"first_name": "JENNA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-09",
"last_updated": "2020-10-09",
"certification_date": "2020-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1333771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Red Oak, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.