Henning Family Practice, LLC
Organization Active NPI Family Medicine Physician · Hardinsburg, KY
NPI 1831864289 · NPPES record last updated Aug 9, 2021
Key facts
- NPI
- 1831864289
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- HENNING FAMILY PRACTICE, LLC
- Practice address
- 124 W 3Rd St
Hardinsburg, KY 40143-2624 - Phone
- (270) 580-4050
- Fax
- (270) 580-4051
- NPI assigned
- Aug 9, 2021
- Organization subpart
- No
Authorized official
- Name
- Alicia C Henning, FNP
- Title
- Owner/Nurse Practitioner
- Phone
- (270) 580-4050
Practitioners 3
-
Alicia Cheryl Henning, APRN
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D2229444 | Henning Family Practice | Certificate of waiver | Jul 12, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220131000286 | KY | Part B Supplier - Clinic/Group Practice | 2466845268 |
Receives reassigned benefits from 3 practitioners Practice locations: Hardinsburg, KY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
124 W 3Rd St
Hardinsburg, KY 40143-2624
Mailing address
124 W 3Rd St
Hardinsburg, KY 40143-2624
Phone (270) 580-4050
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134513559 | Other | INDIVIDUAL NPI | |
| 7100405900 | Medicaid | KY |
Other providers in Hardinsburg, KY
- Hardinsburg Chiropractic, PSC
- Hardinsburg Eyecare Center PLLC
- Hardinsburg Health Center LLC
- Hardinsburg Health Facilities LP
- Erica Hayes
- Alicia Cheryl Henning
- Lori Beth Henning
- David Timothy Hicks
- Emily Royalty Hinton
- Erica Renee Johnston
All providers in Hardinsburg, KY · Family Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.