Mac Henry, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A152358 Issued in CA

Practice address

516 E Nizhoni Blvd
Gallup, NM 87301-5748

Phone

(505) 722-1000

NPI assigned

Feb 4, 2014

Sex

Female

Sole proprietor

No

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

Enrolled in TX, ME2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mhenry561460@direct.mmc.mainehealth.org

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.

• DHHS,PHS,Naihs, Gallup Indian Medical Center

  • General Acute Care Hospital
  • Gallup, NM
  • NPI 1225002322

  TX

  Medicare reassignment NPD
• Bluewater Emergency Partners of Brunswick, LLC

  • Emergency Medicine Physician
  • Brunswick, ME
  • NPI 1043640204
  Medicare reassignment NPD
• Bluewater Emergency Partners of Calais, LLC Dba: Bluewater Urgent Care

  • Emergency Medicine Physician
  • Brunswick, ME
  • NPI 1881974665
  NPD (past)

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

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1174947634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1337",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873051337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 E NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015748",
            "telephone_number": "505-722-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "MAC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-04",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A152358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Davis E Henderson
• Sabor Mae Henderson, FNP-C
• Audra Ruth Hendrix, OTR
• Danielle J. Henio, DA
• Eden Christian Henry
• William S Henry, RN
• Kia Her, RN
• Maureen May Tecson Herbas
• Carol Ann Heredia, LMSW
• Antonia Hernandez, CPNP, RN

• Emergency Medicine Physician in Gallup, NM
• Providers in Gallup, NM by specialty
• Emergency Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.