Active NPI
Henry Eye Clinic
- Ophthalmology Physician
- Fayetteville, AR
National Provider Identifier
1295715936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- 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
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.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 132227002 | Medicaid | AR | |
| 180032208 | Other | AR | RAILROAD MEDICARE |
| 57440 | Other | AR | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050613000646 | AR | Part B Supplier - Clinic/Group Practice | 5193771764 |
Receives reassigned benefits from 5 practitioners Practice locations: Fayetteville, AR |
National Provider Directory
National Provider DirectoryLocations
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
- jstafford@hec.intellechartdirect.net
- kspikes@hec.intellechartdirect.net
- phenry@hec.intellechartdirect.net
- 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.
-
- Optometrist
- Fayetteville, AR
- NPI 1356277479
-
- Clinical Psychologist
- Boca Raton, FL
- NPI 1215031406
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.