Eric J Henry, PT

Individual provider Active NPI Physical Therapist · Mascotte, FL

NPI 1295035012 · NPPES record last updated Mar 22, 2021

Key facts

NPI
1295035012
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT 3096 (AR)
Practice address
15877 Surfbird CT
Mascotte, FL 34753-9116
Phone
(501) 470-5320
NPI assigned
Oct 26, 2010
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

35 SE 1St Ave
Ocala, FL 34471-2176

378 NE 57TH St
Ocala, FL 34479-7602

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260602001305 FL Practitioner - Physical Therapist in Private Practice 3476731951 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT 3096ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Institute Physical Therapist Past
since Jan 1, 2011
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 3096 AR Yes

Addresses

Primary practice location

15877 Surfbird CT
Mascotte, FL 34753-9116

Mailing address

15877 Surfbird CT
Mascotte, FL 34753-9116
Phone (501) 470-5320

Other providers in Mascotte, FL

All providers in Mascotte, FL · Physical Therapist in Florida

Sources for this page

Verify at the official NPI Registry.