Individual provider Active NPI

Albert Lewis Henry, MD

  • Orthopaedic Surgery Physician
  • Fleming Island, FL
National Provider Identifier
1194705574
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
ME54173 Issued in FL
Practice address
4689 US Highway 17
Suite 11 &12
Fleming Island, FL 32003-4831
Phone
(904) 375-9753
Fax
(904) 375-8380
NPI assigned
Jan 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X ME54173 FL Primary
Orthopaedic Trauma Physician 207XX0801X ME54173 FL

Addresses

Primary practice location

4689 US Highway 17
Suite 11 &12
Fleming Island, FL 32003-4831

Mailing address

6262 Veterans Pkwy
Columbus, GA 31909-3540
Phone (706) 494-3071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110318000151 FL Practitioner - Orthopedic Surgery 1355417924 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hughston Orthopaedic Southeast PC Orthopaedic Surgery CurrentSince Jun 1, 2017 Accepting new patients
Hughston Orthopaedic Southeast PC Orthopaedic Surgery CurrentSince Jun 1, 2017 Accepting new patients
Jacksonville Multispecialty Services, LLC Orthopaedic Surgery Past Accepting new patients

Locations

4689 US Highway 17
Ste 11
Orange Park, FL 32003
Phone (904) 269-7007

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

1401 W Seminole Blvd
Fl Regi
Sanford, FL 32771
Phone (407) 302-2620

1403 Medical Plaza Dr
Ste 102
Sanford, FL 32771
Phone (407) 323-7821

6262 Veterans Pkwy
Columbus, GA 31909
Phone (706) 494-3071

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1194705574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6262 VETERANS PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319093540",
            "telephone_number": "706-494-3071",
            "fax_number": "706-494-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4689 US HIGHWAY 17",
            "address_2": "SUITE 11 &12",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034831",
            "telephone_number": "904-375-9753",
            "fax_number": "904-375-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "ALBERT",
        "middle_name": "LEWIS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME54173",
            "primary": true
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "FL",
            "license": "ME54173",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

Verify at the official NPI Registry.