Individual provider Active NPI

Deborah Christine Henry, M.D.

  • Neurological Surgery Physician
  • Newport Beach, CA
National Provider Identifier
1407879950
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
A53188 Issued in CA
Practice address
11 Balboa CV
Newport Beach, CA 92663-3226
Phone
(626) 390-3125
Fax
(949) 645-8788
NPI assigned
Jul 25, 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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X A53188 CA Primary
Neurological Surgery Physician 207T00000X H1968 TX
Neurological Surgery Physician 207T00000X 175365 NY

Addresses

Primary practice location

11 Balboa CV
Newport Beach, CA 92663-3226

Mailing address

PO Box 3545
Newport Beach, CA 92659-8545
Phone (626) 390-3125

Other identifiers 1

IdentifierTypeStateIssuer
00A531880MedicaidCA

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 Medicine

State licenses

LicenseStateTypeSpecialty
175365NYMDNeurological Surgery Physician
H1968TXMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Arcadia Hospital Past Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Deborah C, Henry, M.D., Apc Neurological Surgery Past Accepting new patients

Organizations & group practices 5

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407879950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3545",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926598545",
            "telephone_number": "626-390-3125",
            "fax_number": "949-645-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BALBOA CV",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633226",
            "telephone_number": "626-390-3125",
            "fax_number": "949-645-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "DEBORAH",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A53188",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "H1968",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "175365",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A531880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.