Philip Roger Henry, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0P0001500 Issued in WA

Practice address

42 E Rowan Ave
Suite a
Spokane, WA 99207

Phone

(509) 483-3155

Fax

(509) 483-3270

NPI assigned

Jan 10, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Northside Family Physicians

  • Family Medicine Physician
  • Spokane, WA
  • NPI 1750855276
  NPD (past)

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1023097946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 E ROWAN AVE",
            "address_2": "SUITE A",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99207",
            "telephone_number": "509-483-3155",
            "fax_number": "509-483-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 E ROWAN AVE",
            "address_2": "SUITE A",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99207",
            "telephone_number": "509-483-3155",
            "fax_number": "509-483-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "PHILIP",
        "middle_name": "ROGER",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "0P0001500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0160793",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1116060",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erma Henry, M.A.
• James Henry III
• Joselyn Nicole Henry, CBT
• Kathleen Henry, LMP
• Kristin Henry, LMT
• Vicki Ruth Henry, RN
• Heydon Hensley, LICSW
• Krisanne Lenore Hensley, CDP
• Shantea L Hensley
• Brandy Renee Henson, PH.D

• Family Medicine Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.