Individual provider Active NPI

Paul A Henkel, DO

  • Orthopaedic Surgery Physician
  • Watkinsville, GA
National Provider Identifier
1235484312
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
86314 Issued in GA
Practice address
1305 Jennings Mill Rd Ste 110
Watkinsville, GA 30677-7241
Phone
(706) 613-5880
NPI assigned
Jul 16, 2012
Last updated
Sep 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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 3551 TN
Orthopaedic Surgery Physician 207X00000X 86314 GA Primary

Addresses

Primary practice location

1305 Jennings Mill Rd Ste 110
Watkinsville, GA 30677-7241

Mailing address

PO Box 117265
Atlanta, GA 30368-7265
Phone (706) 369-5440

Other practice location 1

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 224-4000

Other practice location 2

410 N State Of Franklin Rd Ste 140
Johnson City, TN 37604-6972
Phone (423) 431-2460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, TN, GA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20170807001101 MO Practitioner - Orthopedic Surgery 0345511523
I20181015000912 TN Practitioner - Orthopedic Surgery 0345511523 Reassigns benefits to 1 organization
I20200902002285 GA Practitioner - Orthopedic Surgery 0345511523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Athens Specialty Care LLCGroup PAC ID 8820349772, 116 clinicians

Practice addresses (Care Compare)

1305 Jennings Mill Rd
Suite 250
Watkinsville, GA 30677-7241
Phone (706) 475-1700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Athens Specialty Care LLC CurrentSince Aug 1, 2020 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Aug 29, 2018 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Aug 29, 2018 Accepting new patients
Wellmont Medical Associates Inc Orthopaedic Surgery Current Accepting new patients

Locations

340 Exchange Blvd
Bethlehem, GA 30620
Phone (678) 963-7171

1305 Jennings Mill Rd
Ste 110
Watkinsville, GA 30677
Phone (706) 613-5880

1305 Jennings Mill Rd
Ste 250
Watkinsville, GA 30677

410 N State of Franklin Rd
Ste 140
Johnson City, TN 37604
Phone (423) 431-2460

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

111 W Stone Dr
Ste 110
Kingsport, TN 37660
Phone (423) 224-3701

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1235484312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 117265",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303687265",
            "telephone_number": "706-369-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 JENNINGS MILL RD STE 110",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777241",
            "telephone_number": "706-613-5880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 W Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603837",
            "country_code": "US",
            "telephone_number": "423-224-4000",
            "fax_number": "423-224-3215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "410 N State Of Franklin Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046972",
            "country_code": "US",
            "telephone_number": "423-431-2460",
            "fax_number": "423-431-2456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENKEL",
        "first_name": "PAUL",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-16",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "3551",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "86314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkinsville, GA

Sources for this page

Verify at the official NPI Registry.