Henry Ronald Emery Jr., M.D.
Individual provider Active NPI Family Medicine Physician · Weddington, NC
NPI 1639149552 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1639149552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 200300594 (NC)
- Practice address
- 1928 Weddington Rd
Weddington, NC 28104-8318 - Phone
- (704) 667-4280
- Fax
- (704) 667-4281
- NPI assigned
- Jan 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040802000860 | NC | Practitioner - Family Practice | 5193796407 |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington County Healthcare Authority, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 40161 | SC | |
| Family Medicine Physician | 207Q00000X | 00594 | NC | |
| Family Medicine Physician | 207Q00000X | 200300594 | NC | Yes |
Addresses
Primary practice location
1928 Weddington Rd
Weddington, NC 28104-8318
Mailing address
1928 Weddington Rd
Weddington, NC 28104-8318
Phone (704) 844-0505
Other practice location 1
502 Sixth Baxter Xing
Fort Mill, SC 29708-6596
Phone (803) 396-8100
Other practice location 2
1190 Filbert Hwy Ste 110
York, SC 29745-9324
Phone (803) 628-0004
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89134FA | Medicaid | NC | |
| Q0059W | Medicaid | SC |
Other providers in Weddington, NC
- Jennifer Hibbert Coggins
- Daniel Edward Danieley
- Cindy Ejindu
- Elios Anesthesiology Group, PA
- Jamie Nicole Elwell
- Elen Gay
- Tejaswi Gosu
- Michael Grenda
- Meredith Alison Griggs
- Jeffrey Andrew Hamilton
All providers in Weddington, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.