Individual provider Active NPI

David Glen McHenry, MD

  • Neurology Physician
  • Jackson, MS
National Provider Identifier
1053494831
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
11473 Issued in MS
Practice address
971 Lakeland Drive
Suite 557
Jackson, MS 39216
Phone
(601) 200-4560
Fax
(601) 326-4632
NPI assigned
Oct 23, 2006
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 11473 MS
Neurology Physician 2084N0400X 11473 MS Primary
Neurology Physician 2084N0400X 11473 LA

Addresses

Primary practice location

971 Lakeland Drive
Suite 557
Jackson, MS 39216

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 526-0001

Other practice location 1

4204 Clay St
Vicksburg, MS 39183-3438
Phone (601) 200-4560

Other practice location 2

810 E Sunflower Rd Ste 100J
Cleveland, MS 38732-2828
Phone (601) 200-4656

Other identifiers 1

IdentifierTypeStateIssuer
18132MedicaidMS

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://urldefense.proofpoint.com/v2/url?u=https-3A__epicproxy.et0830.epichosted.com_FHIRProxy_api_F Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101006000627 MS Practitioner - Neurology 1456492131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Mississippi School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

106 Highland Way
Madison, MS 39110-6933

969 Lakeland Dr
Jackson, MS 39216-4606
Phone (601) 200-3100

971 Lakeland Dr
Suite 557
Jackson, MS 39216-4661
Phone (601) 200-4560

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.09 of 100Reported as apm
Quality
73.43
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11473LAMDNeurology Physician
11473MSMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Dominic Medical Associates LLC CurrentSince Feb 8, 2014 Accepting new patients
St. Dominic Medical Associates LLC Neurology Current Accepting new patients
St. Dominic Medical Associates LLC CurrentSince Feb 8, 2014 Accepting new patients
St Dominic Medical Associates LLC Past Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

971 Lakeland Dr
Ste 557
Jackson, MS 39216
Phone (601) 200-4560

106 Highland Way
Ste 202
Madison, MS 39110
Phone (601) 200-3376

Networks

  • LA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: dmchenry2548734@direct.casso.us.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1053494831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-526-0001",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DRIVE",
            "address_2": "SUITE 557",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-200-4560",
            "fax_number": "601-326-4632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4204 Clay St",
            "address_purpose": "LOCATION",
            "city": "Vicksburg",
            "state": "MS",
            "postal_code": "391833438",
            "country_code": "US",
            "telephone_number": "601-200-4560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "810 E Sunflower Rd Ste 100J",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "MS",
            "postal_code": "387322828",
            "country_code": "US",
            "telephone_number": "601-200-4656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCHENRY",
        "first_name": "DAVID",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MS",
            "license": "11473",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MS",
            "license": "11473",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "LA",
            "license": "11473",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18132",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://urldefense.proofpoint.com/v2/url?u=https-3A__epicproxy.et0830.epichosted.com_FHIRProxy_api_F",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "309 Jackson St Ste 320",
            "city": "Monroe",
            "state": "LA",
            "country_code": "US",
            "postal_code": "712017407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.