Individual provider Active NPI

Deborah Gilbert Henry, M.D.

  • Internal Medicine Physician
  • East Point, GA
National Provider Identifier
1336176999
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
O41950 Issued in GA
Practice address
1513 E. Cleveland Ave.
East Point, GA 30344
Phone
(404) 321-6111
Fax
(404) 417-1670
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X O41950 GA Primary

Addresses

Primary practice location

1513 E. Cleveland Ave.
East Point, GA 30344

Mailing address

5582 Rutland Trace
Lithonia, GA 30058
Phone (770) 413-2626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150421001251 GA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 7416275540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
O41950GAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336176999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5582 RUTLAND TRACE",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "30058",
            "telephone_number": "770-413-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 E. CLEVELAND AVE.",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "30344",
            "telephone_number": "404-321-6111",
            "fax_number": "404-417-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "DEBORAH",
        "middle_name": "GILBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "O41950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Point, GA

Sources for this page

Verify at the official NPI Registry.