1. Home
  2. Directory
  3. Minnesota
  4. Minneapolis
  5. Dietitian Registered
  6. NPI Profile

THERESA ROSE HENRY RDN, LD
NPI 1770284044
Dietitian, Registered in Minneapolis, MN

Active since March 14, 2023
2540 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 273-5543(612) 273-3014 Get Directions Write a Review

NPPES record last updated: March 15, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Theresa Rose Henry Rdn, Ld NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THERESA ROSE HENRY RDN, LD (NPI 1770284044) is an individual dietitian, registered in Minneapolis, Minnesota, licensed in Minnesota (4732) and active in the NPI registry since March 2023. She is a graduate of Other (2023).

NPPES Registry Identity

NPI1770284044
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameTHERESA ROSE HENRYCredential: RDN, LD
Location Address2540 RIVERSIDE AVEMinneapolis, MN 55454-1431
Mailing Address4530 Park Commons Dr Apt 111Minneapolis, MN 55416-4950
Phone(612) 273-5543
Fax(612) 273-3014
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateMarch 14, 2023
Last NPPES UpdateMarch 15, 2023
NPPES CertifiedMarch 15, 2023
✔ NPI 1770284044 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in MN · 4732
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
2540 RIVERSIDE AVE, Minneapolis, MN 55454
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Theresa Rose Henry Rdn, Ld is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3274008040
PECOS Enrollment IDI20260409000243

Medicare Billing Reassignments

2

Medicare enrollment records show Theresa Henry reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fairview Express Care
0.1 mi
Clinic/Center
2450 RIVERSIDE AVE, STE F140
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 3,633 clinicians in this Medicare group
NPI 1841428745 (612) 672-6999
Fairview Clinics
0.2 mi
Clinic/Center
606 24TH AVE S, STE 602
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,302 clinicians in this Medicare group
NPI 1043516867 (612) 273-6099

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATIE MARIE WARNE MSP, CCC-SLP
Speech-Language Pathologist
2540 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-3000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theresa Henry's NPI number?

The NPI number for Theresa Henry is 1770284044. It was assigned to this individual provider in the NPPES registry on March 14, 2023.

Where is Theresa Henry located?

Theresa Henry practices at 2540 Riverside Ave, Minneapolis, MN 55454. The listed phone number is (612) 273-5543.

What is Theresa Henry's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Theresa Henry enrolled in Medicare?

Yes. Theresa Henry is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Theresa Henry's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Theresa Henry reassigns Medicare benefits to 2 organizations: Fairview Express Care (Minneapolis, MN) and Fairview Clinics (Minneapolis, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Theresa Henry's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Theresa Henry was last updated on March 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.