Kelsey Matthew Henry, D.C.
Individual provider Active NPI Chiropractor · Mason, WV
NPI 1447358205 · NPPES record last updated Oct 22, 2007
Key facts
- NPI
- 1447358205
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 816 (WV)
- Practice address
- 1065 South Second St
Mason, WV 25260-9724 - Phone
- (304) 773-5773
- Fax
- (304) 773-5773
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1065 2ND St
Mason, WV 25260-9724
Phone (304) 773-5773
1065 S 2ND St
Mason, WV 25260-9724
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050919000139 | WV | Practitioner - Chiropractic | 8921030552 | Practice locations: Mason, WV |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3489 | OH | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 816 | WV | Yes |
| Chiropractor | 111N00000X | 3489 | OH |
Addresses
Primary practice location
1065 South Second St
Mason, WV 25260-9724
Mailing address
1065 South Second St
Mason, WV 25260-9724
Phone (304) 773-5773
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2657218 | Medicaid | OH | |
| 3810003445 | Medicaid | WV |
Other providers in Mason, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.