Individual provider Active NPI

Paul A. Henry, PT

  • Physical Therapist
  • Mountain Home, AR
National Provider Identifier
1295840502
Registry record updated Jul 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1565 Issued in AR
Practice address
715 W 6TH St
Ozark Physical Therapy Specialists
Mountain Home, AR 72653-3421
Phone
(870) 424-2224
Fax
(870) 424-0493
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT1565 AR Primary
Physical Therapist 225100000X 103915 MO

Addresses

Primary practice location

715 W 6TH St
Ozark Physical Therapy Specialists
Mountain Home, AR 72653-3421

Mailing address

PO Box 430
Mountain Home, AR 72654-0430
Phone (870) 424-2224

Other identifiers 1

IdentifierTypeStateIssuer
5X108OtherARBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT1565ARMDPhysical Therapist
103915MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Specialists of the Ozarks, LLC Physical Therapist CurrentSince Nov 29, 2013 Accepting new patients
Ozark Shoulder to Hand Center LLC Physical Therapist PastSince Jan 1, 2014 Accepting new patients

Locations

804 Coley Dr
Mountain Home, AR 72653
Phone (870) 424-2224

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.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404345600000",
    "number": "1295840502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726540430",
            "telephone_number": "870-424-2224",
            "fax_number": "870-424-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 W 6TH ST",
            "address_2": "OZARK PHYSICAL THERAPY SPECIALISTS",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533421",
            "telephone_number": "870-424-2224",
            "fax_number": "870-424-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "PAUL",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2014-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT1565",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "103915",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5X108",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.