Individual provider Active NPI

Ann Henley, CNP

  • Nurse Practitioner
  • Fenton, MI
National Provider Identifier
1982877809
Registry record updated Dec 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704216178 Issued in MI
Practice address
445 N Fenway Dr
Fenton, MI 48430-2666
Phone
(810) 750-6060
Fax
(810) 750-6081
NPI assigned
Apr 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704216178 MI Primary

Addresses

Primary practice location

445 N Fenway Dr
Fenton, MI 48430-2666

Mailing address

445 N Fenway Dr
Fenton, MI 48430-2666
Phone (810) 750-6060

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140130001537 MI Practitioner - Nurse Practitioner 3870722473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fenton Family Medicine PCGroup PAC ID 7618006677, 4 clinicians

Practice addresses (Care Compare)

425 N Fenway Dr
Suite B
Fenton, MI 48430-3810
Phone (810) 750-6060

445 N Fenway Dr
Fenton, MI 48430-2666
Phone (810) 750-6060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Indira Alluru MD PC Current Accepting new patients
Fenton Family Medicine, P.C. CurrentSince Jan 6, 2014 Accepting new patients

Locations

445 N Fenway Dr
Fenton, MI 48430
Phone (810) 616-7246

Interoperability endpoints

  • Direct secure messaging: annhenley@pmi.allscriptsdirect.net

Organizations & group practices 2

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": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386547200000",
    "number": "1982877809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 N FENWAY DR",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302666",
            "telephone_number": "810-750-6060",
            "fax_number": "810-750-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 N FENWAY DR",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302666",
            "telephone_number": "810-750-6060",
            "fax_number": "810-750-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENLEY",
        "first_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-11",
        "last_updated": "2013-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704216178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

Verify at the official NPI Registry.