Active NPI
Anthony C Henry, DO
- Family Medicine Physician
- Fort Wayne, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 02001404A
- 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, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100329430 | Medicaid | IN | |
| P00970619 | Other | IN | RAILROAD MEDICARE |
| 000000091891 | Other | BLUE 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
Enrollment records 1
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
Practice addresses (Care Compare)
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258
Hospital & facility affiliations
- Indiana University Health Ball Memorial Hospital
- Parkview Regional Medical Center
- Dupont Hospital LLC
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02001404A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana University Health Fort Wayne Physicians, LLC | Family Medicine | Current | Accepting new patients |
| Iu Health Medical Group, LLC | Current | 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
- 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.
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
-
- Family Medicine Physician
- Muncie, IN
- NPI 1316550445
-
- Diagnostic Radiology Physician
- Fort Wayne, IN
- NPI 1073584587
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Muncie, IN
- NPI 1225195340
-
dba Parkview Regional Medical Center
- General Acute Care Hospital
- Fort Wayne, IN
- NPI 1366407603
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.