Mark R Henry, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

054271 Issued in MI

Practice address

1125 Michigan Ave E
Suite 5
Battle Creek, MI 49014-6832

Phone

(269) 969-6014

Fax

(269) 969-6085

NPI assigned

Jun 7, 2006

Last updated

Apr 29, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

• Wattles Park Family Practice PC

  • Family Medicine Physician
  • Battle Creek, MI
  • NPI 1659512705
  Authorized official Same address or phone

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1164462354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 MICHIGAN AVE E",
            "address_2": "SUITE 5",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490146832",
            "telephone_number": "269-969-6014",
            "fax_number": "269-969-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 MICHIGAN AVE E",
            "address_2": "SUITE 5",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490146832",
            "telephone_number": "269-969-6014",
            "fax_number": "269-969-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "MARK",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "054271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4227999",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Hendrix, DONA DOULA
• Daniel Henriquez II, LMT
• Henry J. Brown, D.D.S.P.C. (Brown Family Dentistry)
• Desiree Henry, MA
• Lesa Henry
• Ronna J. Henry, RN
• Steven D. Henry, FNP
• Corena Lene Herder
• Heritage Interfaith Counseling Center
• Darcy Lyn Herrera, LMSW

• Family Medicine Physician in Battle Creek, MI
• Providers in Battle Creek, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.