Individual provider Active NPI

Jolene Bryner Henshaw, M.D.

  • Surgery Physician
  • Blacksburg, VA
National Provider Identifier
1164549978
Registry record updated Aug 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101241379 Issued in VA
Practice address
830 Hospital Dr
Blacksburg, VA 24060-7023
Phone
(540) 951-0780
Fax
(540) 951-0782
NPI assigned
Mar 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101241379 VA Primary

Addresses

Primary practice location

830 Hospital Dr
Blacksburg, VA 24060-7023

Mailing address

830 Hospital Dr
Blacksburg, VA 24060-7023
Phone (540) 951-0780

Other identifiers 1

IdentifierTypeStateIssuer
1164549978MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20080616000534 VA Practitioner - General SurgeryPractitioner - Vascular Surgery 7719058916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Arizona College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lewis Gale Physicians LLCGroup PAC ID 6507886231, 191 clinicians

Practice addresses (Care Compare)

809 Davis St
Suite Ste1
Blacksburg, VA 24060-7013
Phone (540) 961-1590

Hospital & facility affiliations

  • Lewisgale Hospital Montgomery Hospital, Blacksburg, VA, CCN 490110
  • Lewisgale Medical Center Hospital, Salem, VA, CCN 490048
  • Carilion New River Valley Medical Center Hospital, Christiansburg, VA, CCN 490042
  • Lewisgale Hospital Pulaski Hospital, Pulaski, VA, CCN 490116

Merit-based Incentive Payment System (MIPS)

Final score
82.67 of 100Reported as group
Quality
66.8
Promoting interoperability
100
Improvement activities
40
Cost
75.45

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy74
Removal of tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis Gale Physicians LLC CurrentSince Oct 1, 2019 Accepting new patients
Surgical Associates of the New River Valley LLC Surgery Past Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

817 Davis St
Ste A
Blacksburg, VA 24060
Phone (540) 443-3940

801 Davis St
Ste 1
Blacksburg, VA 24060
Phone (540) 961-0218

809 Davis St
#1
Blacksburg, VA 24060
Phone (540) 951-0780

817 Davis St
Ste 1
Blacksburg, VA 24060
Phone (540) 552-3670

1802 Braeburn Dr
Salem, VA 24153
Phone (540) 772-3400

1802 Braeburn Dr
Ste 2
Salem, VA 24153

1802 Braeburn Dr
Ste 3
Salem, VA 24153

1802 Braeburn Dr
#2
Salem, VA 24153

1802 Braeburn Dr
#3
Salem, VA 24153

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250121600000",
    "number": "1164549978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 HOSPITAL DR",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607023",
            "telephone_number": "540-951-0780",
            "fax_number": "540-951-0782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 HOSPITAL DR",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607023",
            "telephone_number": "540-951-0780",
            "fax_number": "540-951-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSHAW",
        "first_name": "JOLENE",
        "middle_name": "BRYNER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-25",
        "last_updated": "2009-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101241379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164549978",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

Verify at the official NPI Registry.