Active NPI
Forrest E Henry, DO
- Family Medicine Physician
- Lordsburg, NM
National Provider Identifier
1407810179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A-1382-06
- Practice address
- 530 Demoss Street
Lordsburg, NM 88045-2618 - Phone
- (575) 542-2313
- Fax
- (575) 542-2388
- NPI assigned
- Apr 12, 2006
- Last updated
- Feb 14, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | T-252 | NM | |
| Family Medicine Physician | 207Q00000X | A-1382-06 | NM | Primary |
Addresses
Primary practice location
530 Demoss Street
Lordsburg, NM 88045-2618
Mailing address
530 Demoss Street
Lordsburg, NM 88045-2618
Phone (575) 542-2313
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 67570364 | Medicaid | NM |
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T-252 | NM | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360800000000",
"number": "1407810179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 DEMOSS STREET",
"city": "LORDSBURG",
"state": "NM",
"postal_code": "880452618",
"telephone_number": "575-542-2313",
"fax_number": "575-542-2388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 DEMOSS STREET",
"city": "LORDSBURG",
"state": "NM",
"postal_code": "880452618",
"telephone_number": "575-542-2313",
"fax_number": "575-542-2388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRY",
"first_name": "FORREST",
"middle_name": "E",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-12",
"last_updated": "2013-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NM",
"license": "T-252",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NM",
"license": "A-1382-06",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "67570364",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lordsburg, NM
- Dara Ann Foster, CNP
- Jayson Garcia-Gurule
- Genoa Healthcare LLC
- Edgar Eduardo Gomez, ASSOCAITES OF ARTS/
- Terri E Gomez, LBSW
- Hidalgo County (Hidalgo County DWI Prevention Program)
- Hidalgo Medical Services (HMS)
- Hidalgo Medical Services (HMS)
- Hidalgo Medical Services
- Hidalgo Medical Services (HMS Lordsburg High School Health Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.