Millard Thomas Hennessee, D.P.M

Primary specialty

PodiatristTaxonomy code 213E00000X

License

001614 Issued in MA

Practice address

654 E Broadway
Boston, MA 02127-1502

Phone

(617) 268-1745

Fax

(617) 268-1748

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345075200000",
    "number": "1285666222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 E BROADWAY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021271502",
            "telephone_number": "617-268-1745",
            "fax_number": "617-268-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 E BROADWAY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021271502",
            "telephone_number": "617-268-1745",
            "fax_number": "617-268-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSEE",
        "first_name": "MILLARD",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2012-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "001614",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MA",
            "license": "001614",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "Y70691",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0341487",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Daniel Henkel, MD, PHD
• Karen M Henley, MD
• Rosemary E Henn, MD, PHD
• Natalia Henner, MD
• Ryan Henner, M.D.
• Susan A Hennessey-Power, FNP-BC
• Ann-Marie B Hennessey, M.A., CCC-A
• James V Hennessey, MD
• Lindsay Elizabeth Hennessey, AGNP
• Kerry Sheila Hennessy, LICSW

• Podiatrist in Boston, MA
• Providers in Boston, MA by specialty
• Podiatrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.