Individual provider Active NPI

Mark F Henry, M.D.

  • Orthopaedic Surgery Physician
  • Brunswick, ME
National Provider Identifier
1194794677
Registry record updated Jan 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
011476 Issued in ME
Practice address
430 Bath Rd
Suite 102
Brunswick, ME 04011-2637
Phone
(207) 442-0350
Fax
(207) 442-0355
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 011476 ME Primary

Addresses

Primary practice location

430 Bath Rd
Suite 102
Brunswick, ME 04011-2637

Mailing address

430 Bath Rd
Suite 102
Brunswick, ME 04011-2637
Phone (207) 442-0350

Other identifiers 1

IdentifierTypeStateIssuer
270740099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011476MEMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Orthopedics & Sports Medicine,P.a. Past Accepting new patients

Organizations & group practices 1

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1194794677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 BATH RD",
            "address_2": "SUITE 102",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112637",
            "telephone_number": "207-442-0350",
            "fax_number": "207-442-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 BATH RD",
            "address_2": "SUITE 102",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112637",
            "telephone_number": "207-442-0350",
            "fax_number": "207-442-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "MARK",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ME",
            "license": "011476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270740099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

Verify at the official NPI Registry.