Active NPI
Paul A. Henry, PT
- Physical Therapist
- Mountain Home, AR
National Provider Identifier
1295840502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT1565
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5X108 | Other | AR | BCBS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT1565 | AR | MD | Physical Therapist |
| 103915 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Therapy Specialists of the Ozarks, LLC | Physical Therapist | Current | Accepting new patients |
| Ozark Shoulder to Hand Center LLC | Physical Therapist | Past | 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.
-
- Rehabilitation Clinic/Center
- Mountain Home, AR
- NPI 1538597646
Physical Therapist
-
- Occupational Therapist
- Mountain Home, AR
- NPI 1750711743
Physical Therapist
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.