Henry Chiropractic Clinic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

965 Issued in MS

Legal business name

HENRY CHIROPRACTIC CLINIC PLLC

Practice address

8820 Goodman Rd
Olive Branch, MS 38654-2204

Phone

(662) 890-5454

Fax

(662) 893-8343

NPI assigned

Jan 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Brian K Henry, D.C.NPI 1346239290

Title

Owner Doctor

Phone

(662) 890-5454

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian Keith Henry, D.C.

  • Chiropractor
  • Olive Branch, MS
  • NPI 1346239290
  Medicare reassignment NPD Authorized official
• Lesa Beaver, NP

  • Acute Care Nurse Practitioner
  • Jackson, MS
  • NPI 1861680670
  NPD (past)
• John Paul Hope II, D.C.

  • Chiropractor
  • Olive Branch, MS
  • NPI 1699013680
  NPD (past)
• Russell Howard Mauk, DC

  • Chiropractor
  • Olive Branch, MS
  • NPI 1770509929
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445385600000",
    "number": "1174676647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8820 GOODMAN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386542204",
            "telephone_number": "662-890-5454",
            "fax_number": "662-893-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8820 GOODMAN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386542204",
            "telephone_number": "662-890-5454",
            "fax_number": "662-893-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY CHIROPRACTIC CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2015-10-21",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "662-890-5454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. BRIAN K HENRY NPI",
            "identifier": "1346239290",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6332775",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "4430072",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "428516988B",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE DME",
            "identifier": "6241720001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1174676647",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "4433003",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5455686",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4140696",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP PTAN",
            "identifier": "512G700109",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heart of Hospice, LLC
• Heart to Heart PCS Agency
• Laportia Franks Hence
• Mark Henderson
• Valerian Keith Hendrix Sr., ACNP/FNP
• Brian Keith Henry, D.C.
• Julie Tremor Hicks, M.D.
• Kerry Hicks, NP
• Milejah Diane Higgins, PHARMD
• Heather Hildebrant, PMHNP

• Chiropractor in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Chiropractor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.