Kenneth Roy Henry, P.A.-C.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

749 Issued in TN

Practice address

3939 Central Pike
Hermitage, TN 37076-3499

Phone

(615) 883-2331

NPI assigned

Aug 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, TX2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  Medicare reassignment NPD
• Choctaw Nation of Oklahoma

  • Rural Acute Care Hospital
  • Talihina, OK
  • NPI 1659347623

  TX

  Medicare reassignment
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Kyle, SD
  • NPI 1003963497

  TX

  Medicare reassignment
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Choctaw Nation of Oklahoma

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Broken Bow, OK
  • NPI 1447143532
  NPD
• Choctaw Nation of Oklahoma

  • Primary Care Clinic/Center
  • Poteau, OK
  • NPI 1710953799
  NPD
• Urgent Care Enterprise LLC

  • Urgent Care Clinic/Center
  • Antioch, TN
  • NPI 1477087658
  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334880000000",
    "number": "1295748408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 NEW HALLTOWN RD",
            "city": "HARTSVILLE",
            "state": "TN",
            "postal_code": "370741929",
            "telephone_number": "615-374-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 CENTRAL PIKE",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370763499",
            "telephone_number": "615-883-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "KENNETH",
        "middle_name": "ROY",
        "name_prefix": "Mr.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2012-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Dale Head, DPM
• Health Center of Hermitage
• Heart to Heart Holistic Private Care Services
• Helping Hands Support Center, Inc.
• Michael B Hemphill, MD
• Sunny Henry, DPT
• Hermitage Alf Opco LLC
• Hermitage Chiropractic and Rehabilitation PLLC
• Hermitage Chiropractic, LLC
• Hermitage Cosmetic and Implant Dentistry Mark H Whitefield DDS Gen PTR

• Medical Physician Assistant in Hermitage, TN
• Providers in Hermitage, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.