Individual provider Active NPI

Brian Keith Henry, D.C.

  • Chiropractor
  • Olive Branch, MS
National Provider Identifier
1346239290
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
965 Issued in MS
Practice address
8820 Goodman Rd
Olive Branch, MS 38654-2204
Phone
(662) 890-5454
Fax
(662) 893-8343
NPI assigned
Oct 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 965 MS Primary

Addresses

Primary practice location

8820 Goodman Rd
Olive Branch, MS 38654-2204

Mailing address

8820 Goodman Rd
Olive Branch, MS 38654-2204
Phone (662) 890-5454

Other identifiers 6

IdentifierTypeStateIssuer
6241720001OtherCIGNA GOVERNMENT SERVICES
5455686OtherMSAETNA
4433003OtherTNUNITED HEALTHCARE
3149677OtherTNB/C B/S OF TN
6332775OtherMSCIGNA
4430072OtherMSUNITED HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060111000617 MS Practitioner - Chiropractic 7618885401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8820 Goodman Rd
Olive Branch, MS 38654-2204
Phone (662) 890-5454

Merit-based Incentive Payment System (MIPS)

Final score
26.87 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
89.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
965MSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Chiropractic Clinic PLLC Chiropractor CurrentSince Dec 22, 2005 Accepting new patients
Henry Health & Wellness, LLC Chiropractor PastSince Dec 28, 2013 Accepting new patients

Locations

2620 Highway 51 S
Hernando, MS 38632
Phone (662) 449-7534

8820 Goodman Rd
Olive Branch, MS 38654
Phone (662) 890-5454

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1346239290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8820 GOODMAN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386542204",
            "telephone_number": "662-890-5454",
            "fax_number": "662-893-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8820 GOODMAN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386542204",
            "telephone_number": "662-890-5454",
            "fax_number": "662-893-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GOVERNMENT SERVICES",
            "identifier": "6241720001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5455686",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "4433003",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/C B/S OF TN",
            "identifier": "3149677",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6332775",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "4430072",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.