Organization Active NPI

Henry Eye Clinic

  • Ophthalmology Physician
  • Fayetteville, AR
National Provider Identifier
1295715936
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
HENRY EYE CLINIC
Practice address
741 E Van Asche Dr
Fayetteville, AR 72703-4916
Phone
(479) 442-5227
Fax
(479) 582-4952
NPI assigned
Jan 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Authorized official

Name
Dr. Paul Morriss Henry, M.D.NPI 1598745713
Title
Ophthalmologist
Phone
(479) 442-5227

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

741 E Van Asche Dr
Fayetteville, AR 72703-4916

Mailing address

741 E Van Asche Dr
Fayetteville, AR 72703-4916
Phone (479) 442-5227

Other identifiers 3

IdentifierTypeStateIssuer
132227002MedicaidAR
180032208OtherARRAILROAD MEDICARE
57440OtherARBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050613000646 AR Part B Supplier - Clinic/Group Practice 5193771764 Receives reassigned benefits from 5 practitioners
Practice locations: Fayetteville, AR

National Provider Directory

National Provider Directory

Locations

741 E Van Asche Dr
Fayetteville, AR 72703
Phone 47942252271208

601 W Maple Ave
Ste 208
Springdale, AR 72764
Phone (501) 927-2020

Interoperability endpoints

  • Direct secure messaging: jstafford@hec.intellechartdirect.net
  • Direct secure messaging: kspikes@hec.intellechartdirect.net
  • Direct secure messaging: phenry@hec.intellechartdirect.net
  • Direct secure messaging: pdaut@hec.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695254400000",
    "number": "1295715936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 E VAN ASCHE DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034916",
            "telephone_number": "479-442-5227",
            "fax_number": "479-582-4952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 E VAN ASCHE DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034916",
            "telephone_number": "479-442-5227",
            "fax_number": "479-582-4952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY EYE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "MORRISS",
        "authorized_official_title_or_position": "OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "479-442-5227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132227002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180032208",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "57440",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.