Individual provider Active NPI

Stephen Henson, MD

  • Otolaryngology Physician
  • Lafayette, IN
National Provider Identifier
1902875586
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
010280084A Issued in IN
Practice address
2600 Greenbush St
Lafayette, IN 47904-2479
Phone
(765) 448-8000
Fax
(765) 448-7625
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 010280084A IN Primary

Addresses

Primary practice location

2600 Greenbush St
Lafayette, IN 47904-2479

Mailing address

1200 W White River Blvd
Muncie, IN 47303-4988
Phone (877) 668-5621

Other identifiers 5

IdentifierTypeStateIssuer
10825262OtherINCAQH NUMBER
HE80478004MedicaidIN
100231190MedicaidIN
000000179580OtherINANTHEM PROVIDER NUMBER
9039384OtherINPHCS PID NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hensons@direct.iuhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20050414001315 IN Practitioner - Otolaryngology 9638116155 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
010280084AINMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arnett Clinic, LLC Current Accepting new patients
Arnett Clinic, LLC Otolaryngology CurrentSince Apr 1, 1998 Accepting new patients
Arnett Clinic, LLC CurrentSince Apr 1, 1998 Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

550 S Hoke Ave
Frankfort, IN 46041
Phone (765) 659-1110

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1500 Salem St
Lafayette, IN 47904
Phone (765) 420-1400

2600 Greenbush St
Lafayette, IN 47904

1200 W White River Blvd
Muncie, IN 47303
Phone (765) 254-4009

Interoperability endpoints

  • Direct secure messaging: hensons@direct.iuhealth.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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1902875586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W WHITE RIVER BLVD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473034988",
            "telephone_number": "877-668-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 GREENBUSH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042479",
            "telephone_number": "765-448-8000",
            "fax_number": "765-448-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSON",
        "first_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "010280084A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "10825262",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HE80478004",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100231190",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000179580",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS PID NUMBER",
            "identifier": "9039384",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hensons@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "2600 GREENBUSH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479042479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.