Lyle Gene Henry, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

18454 Issued in WI

Practice address

2350 N Lake Dr
Suite 304
Milwaukee, WI 53211-4528

Phone

(414) 298-7220

Fax

(414) 298-7229

NPI assigned

Jul 7, 2006

Last updated

Feb 25, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11299/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Madison Medical Affiliates, Inc.

  • General Practice Physician
  • Milwaukee, WI
  • NPI 1588695746
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1043242035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 N JEFFERSON ST",
            "address_2": "SUITE 300/ATTN KAAREN BUTZEN",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023718",
            "telephone_number": "414-272-8950",
            "fax_number": "414-272-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N LAKE DR",
            "address_2": "SUITE 304",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114528",
            "telephone_number": "414-298-7220",
            "fax_number": "414-298-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "LYLE",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "18454",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WI",
            "license": "18454",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043242035",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frederick Henry, MS CCC-SLP
• Jennifer L Henry, MSW, CSAC, ICS, CSW
• Jennifer Lynn Henry, R.D.H.
• Joseph Henry IV, PHARMD
• Kathryn Lee Henry
• Matthew Henry, MD
• Peter A Henry, M.D.
• Valencia Henry, DO
• Wesley Henry, RN
• Kathryn Geroulis Henschel, PT

• Surgery Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.