Active NPI
William O Henry, MD
- Specialist
- Gulfport, MS
National Provider Identifier
1144363771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 08744
- Practice address
- 14245 Dedeaux Rd
Gulfport, MS 39503-3369 - Phone
- (228) 314-7226
- Fax
- (228) 314-7227
- NPI assigned
- Feb 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 08744 | MS | Primary |
| Specialist | 174400000X | F7484 | TX |
Addresses
Primary practice location
14245 Dedeaux Rd
Gulfport, MS 39503-3369
Mailing address
PO Box 2819
Gulfport, MS 39505-2819
Phone (228) 314-7226
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1906808 | Medicaid | LA | |
| 3504397 | Medicaid | MT | |
| 10410 | Medicaid | MS | |
| 1995131 | Medicaid | TN | |
| X9X008188 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F7484 | TX | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gulf Coast Imaging | Specialist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Specialist
- Gulfport, MS
- NPI 1205850773
-
- Physiological Laboratory
- Gulfport, MS
- NPI 1265457030
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1144363771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2819",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395052819",
"telephone_number": "228-314-7226",
"fax_number": "228-314-7227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14245 DEDEAUX RD",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395033369",
"telephone_number": "228-314-7226",
"fax_number": "228-314-7227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRY",
"first_name": "WILLIAM",
"middle_name": "O",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-14",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MS",
"license": "08744",
"primary": true
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TX",
"license": "F7484",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1906808",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3504397",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10410",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1995131",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "X9X008188",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.