Nickson Henry, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2263 Issued in GA

Practice address

3564 Highway 138 SE
Stockbridge, GA 30281-4170

Phone

(770) 474-5617

Fax

(770) 474-6576

NPI assigned

Jun 26, 2006

Last updated

Sep 3, 2014By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Henry Vision Center LLC

  • Optometrist
  • Stockbridge, GA
  • NPI 1740420983
  Medicare reassignment NPD Authorized official
• Depoe Eye Center PC

  • Optometrist
  • Stockbridge, GA
  • NPI 1073730263
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1043247380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3564 HIGHWAY 138 SE",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302814170",
            "telephone_number": "770-474-5617",
            "fax_number": "770-474-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3564 HIGHWAY 138 SE",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302814170",
            "telephone_number": "770-474-5617",
            "fax_number": "770-474-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "NICKSON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "2263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "238123293B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Henry Internal Medicine PC
• Henry OB/GYN Associates, PC.
• Henry Radiation Oncology Center, LLC
• Henry Vision Center LLC
• Edwina Henry, MD
• Shane L Henry
• Henry's Home Care Services, LLC
• Kathlene Herbermann, AA
• Here 4 U Lifestyle Management
• Heritage Care Place LLC

• Optometrist in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.