Individual provider Active NPI

Henry Charles Guthery III, MD

  • Family Medicine Physician
  • Villa Rica, GA
National Provider Identifier
1255787651
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
83229 Issued in GA
Practice address
412 Westview Dr
Villa Rica, GA 30180-1717
Phone
(770) 462-1100
Fax
(770) 462-1105
NPI assigned
May 4, 2016
Last updated
Jul 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 83229 GA Primary

Addresses

Primary practice location

412 Westview Dr
Villa Rica, GA 30180-1717

Mailing address

412 Westview Dr
Villa Rica, GA 30180-1717
Phone (770) 462-1100

Other practice location 1

809 W Bankhead Hwy Ste D
Villa Rica, GA 30180-1520
Phone (678) 615-9519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20190909000872 GA Practitioner - Family Practice 9830479492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

412 Westview Dr
Villa Rica, GA 30180-1717
Phone (770) 462-1100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions23
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Group, P.C. Single Specialty CurrentSince Jun 13, 2021 Accepting new patients
Guthery Family Practice Clinic Single Specialty CurrentSince Nov 25, 2020 Accepting new patients

Locations

17 Collins Dr
Cartersville, GA 30120
Phone (770) 386-9390

809 W Bankhead Hwy
Ste D
Villa Rica, GA 30180
Phone (678) 615-9519

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIGCCD/Endpoint/DIGCCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

Organizations & group practices 2

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 2

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": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1255787651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 WESTVIEW DR",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301801717",
            "telephone_number": "770-462-1100",
            "fax_number": "770-462-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 WESTVIEW DR",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301801717",
            "telephone_number": "770-462-1100",
            "fax_number": "770-462-1105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "809 W Bankhead Hwy Ste D",
            "address_purpose": "LOCATION",
            "city": "Villa Rica",
            "state": "GA",
            "postal_code": "301801520",
            "country_code": "US",
            "telephone_number": "678-615-9519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTHERY",
        "first_name": "HENRY",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-04",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "83229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

Verify at the official NPI Registry.