Michael P Henry, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

106206 Issued in MO

Practice address

16533 N State Highway 5 Ste 201
Sunrise Beach, MO 65079-6769

Phone

(573) 374-4600

Fax

(573) 374-4608

NPI assigned

Jun 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Big Springs Medical Association

  • Federally Qualified Health Center (FQHC)
  • Van Buren, MO
  • NPI 1225045321
  Medicare reassignment NPD
• Big Springs Medical Association

  • Federally Qualified Health Center (FQHC)
  • Poplar Bluff, MO
  • NPI 1083745475
  NPD
• Big Springs Medical Association

  • Federally Qualified Health Center (FQHC)
  • Poplar Bluff, MO
  • NPI 1972466233
  NPD
• Carthage Emergency Physicians LLC

  • Emergency Medicine Physician
  • Carthage, MO
  • NPI 1598893877
  NPD (past)
• County of St Louis Division of Fiscal Management

  • Federally Qualified Health Center (FQHC)
  • Berkeley, MO
  • NPI 1184519506
  NPD (past)
• Dexter Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Dexter, MO
  • NPI 1154365070
  NPD (past)
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394928000000",
    "number": "1629014766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16533 N STATE HIGHWAY 5 STE 201",
            "city": "SUNRISE BEACH",
            "state": "MO",
            "postal_code": "650796769",
            "telephone_number": "573-374-4600",
            "fax_number": "573-374-4608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16533 N STATE HIGHWAY 5 STE 201",
            "city": "SUNRISE BEACH",
            "state": "MO",
            "postal_code": "650796769",
            "telephone_number": "573-374-4600",
            "fax_number": "573-374-4608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2014-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "106206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "247988462",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P01155055",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Butler
• Cammo Ambulance District
• Wendy Castle
• Evans Drugs Sunrise Beach LLC
• Healing Connections Counseling Center, LLC
• Carlen Danielle Hite
• Inner Journey Mental Health
• Brandon Keith Johns, D.C.
• Amber Dawn Johnson, LCSW
• Elizabeth Ann Myers

• Family Medicine Physician in Sunrise Beach, MO
• Providers in Sunrise Beach, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.