Henry Allen Locus, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2569 Issued in FL

Practice address

1421 E Oakland Park Blvd Ste 200
Oakland Park, FL 33334-4434

Phone

(954) 565-0875

Fax

(954) 565-0876

NPI assigned

Apr 7, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1083939615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 E OAKLAND PARK BLVD STE 200",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333344434",
            "telephone_number": "954-565-0875",
            "fax_number": "954-565-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 E OAKLAND PARK BLVD STE 200",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333344434",
            "telephone_number": "954-565-0875",
            "fax_number": "954-565-0876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCUS",
        "first_name": "HENRY",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-07",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA2569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; 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.