Individual provider Active NPI

Anthony C Henry, DO

  • Family Medicine Physician
  • Fort Wayne, IN
National Provider Identifier
1609867019
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02001404A Issued in IN
Practice address
10215 Auburn Park Dr
Fort Wayne, IN 46825-2387
Phone
(260) 234-5400
Fax
(260) 234-5110
NPI assigned
Nov 3, 2005
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02001404A IN Primary

Addresses

Primary practice location

10215 Auburn Park Dr
Fort Wayne, IN 46825-2387

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

2512 E DuPont Rd Ste 210
Fort Wayne, IN 46825-1609
Phone (260) 458-3723

Other practice location 2

2516 E DuPont Rd
Fort Wayne, IN 46825-1608
Phone (260) 489-0842

Other identifiers 3

IdentifierTypeStateIssuer
100329430MedicaidIN
P00970619OtherINRAILROAD MEDICARE
000000091891OtherBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20040826000922 IN Practitioner - Family Practice 2062487846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
R Franklin University of Med & Sci/Chicago Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02001404AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Fort Wayne Physicians, LLC Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients
Summit Radiology P C Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

10215 Auburn Park Dr
Fort Wayne, IN 46825
Phone (260) 490-2229

2510 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 489-6440

2512 E DuPont Rd
Ste 210
Fort Wayne, IN 46825
Phone (260) 497-0084

256 E Pettit Ave
Ste 100
Fort Wayne, IN 46806

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

207 N Townline Rd
Lagrange, IN 46761
Phone (260) 266-5300

1200 W White River Blvd
Muncie, IN 47303
Phone (765) 254-4009

Interoperability endpoints

  • Direct secure messaging: ahenry10@direct.iuhealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1609867019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10215 AUBURN PARK DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252387",
            "telephone_number": "260-234-5400",
            "fax_number": "260-234-5110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2512 E DuPont Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468251609",
            "country_code": "US",
            "telephone_number": "260-458-3723",
            "fax_number": "260-458-3724",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2516 E DuPont Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468251608",
            "country_code": "US",
            "telephone_number": "260-489-0842",
            "fax_number": "260-489-1573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRY",
        "first_name": "ANTHONY",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02001404A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100329430",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00970619",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000091891",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.