Individual provider Active NPI

Kelly Henry, NNP

  • Neonatal Nurse Practitioner
  • Fort Bragg, NC
National Provider Identifier
1245724723
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
5014289 Issued in NC
Practice address
2817 Rock Merritt Ave Womack Army Medical Center
Fort Bragg, NC 28310-0001
Phone
(910) 907-8922
Fax
(910) 907-6069
NPI assigned
Jun 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 5014289 NC Primary

Addresses

Primary practice location

2817 Rock Merritt Ave Womack Army Medical Center
Fort Bragg, NC 28310-0001

Mailing address

2817 Rock Merritt Ave Womack Army Medical Center
Fort Bragg, NC 28310-0001
Phone (910) 907-8922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240410000112 NC Practitioner - Nurse Practitioner 9931547999 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5014289NCMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hugh Chatham Memorial Hospital, Inc CurrentSince Mar 27, 2024 Accepting new patients
Hugh Chatham Memorial Hospital, Inc CurrentSince Mar 27, 2024 Accepting new patients
Hugh Chatham Memorial Hospital, Inc. Current Accepting new patients
Hugh Chatham Memorial Hospital Past Accepting new patients
Hugh Chatham Memorial Hospital, Inc. Past Accepting new patients

Locations

150 Parkwood Dr
Elkin, NC 28621
Phone (336) 526-2629

360 Parkwood Medical Park
Elkin, NC 28621
Phone (336) 527-5960

600 Chatham Medical Park
Elkin, NC 28621
Phone (336) 527-7000

680 Parkwood Medical Park
Elkin, NC 28621
Phone (336) 527-8359

180 Parkwood Dr
Elkin, NC 28621
Phone (336) 527-7000

5229 Rock Creek Rd
Hays, NC 28635
Phone (336) 696-2711

Organizations & group practices 5

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": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1245724723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "KELLY",
        "name_prefix": "Mr.",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-19",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NC",
            "license": "5014289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, NC

Sources for this page

Verify at the official NPI Registry.