Barry Merle Henderson, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

016246 Issued in GA

Practice address

Rivers State Prison
Medical Department
Hardwick, GA 31034-1500

Phone

(478) 445-6774

NPI assigned

May 21, 2007

Last updated

Jul 8, 2007By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114135118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3634 SUSSEX DR NE",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310619339",
            "telephone_number": "478-445-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RIVERS STATE PRISON",
            "address_2": "MEDICAL DEPARTMENT",
            "city": "HARDWICK",
            "state": "GA",
            "postal_code": "310341500",
            "telephone_number": "478-445-6774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "BARRY",
        "middle_name": "MERLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "016246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Hale Burnside II, MD
• David Umeadi Ekwunife, MD
• Stanley Chris Gay, DMD
• Voyne Souter, FNP-C

• General Practice Physician in Hardwick, GA
• Providers in Hardwick, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.