Jack Henry, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

D1880 Issued in TX

Practice address

4004 82ND St
Lubbock, TX 79423-1900

Phone

(806) 722-3100

NPI assigned

Feb 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jack.henry@direct.myteamcare.com

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.

• Jack H. Henry MD PA

  • Orthopaedic Surgery Physician
  • Lubbock, TX
  • NPI 1093744989
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1023080652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 82ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231900",
            "telephone_number": "806-722-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 82ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794231900",
            "telephone_number": "806-722-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "D1880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099944301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048641703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Elizabeth Henning, D.O.
• Christopher Shaun Hennington, LPC-S
• Elizabeth Hennington, LPC
• Lauren Henriksen
• Britni Henry, MMFT, LMFT ASSOCIATE
• Melissa Henry, MD
• Sierra Danielle Henry
• Twain Michael Henry II, DDS
• Frederick John Hensal, MD
• Sharon Ann Hensley-Barbee, LPC

• Orthopaedic Surgery Physician in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.