Individual provider Active NPI

Rhonda A Henry, O.D.

  • Optometrist
  • Largo, MD
National Provider Identifier
1639219975
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1280 Issued in MD
Practice address
1221 Mercantile Lane
Largo, MD 20774
Phone
(301) 618-5578
Fax
(301) 618-5673
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1280 MD Primary

Addresses

Primary practice location

1221 Mercantile Lane
Largo, MD 20774

Mailing address

2101 East Jefferson Street
Kaiser Permanente, Ppqa, 6 West, Attn: Theresa Brooks
Rockville, MD 20852
Phone (301) 816-6660

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040318001389 DC Practitioner - Optometry 4981594223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
George Washington University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA1280MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Optometrist CurrentSince Jan 16, 2003 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 16, 2003 Accepting new patients

Locations

2101 E Jefferson St
Ste 6
Rockville, MD 20852

2101 E Jefferson St
#6W
Rockville, MD 20852
Phone (301) 816-6660

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1639219975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 EAST JEFFERSON STREET",
            "address_2": "KAISER PERMANENTE, PPQA, 6 WEST, ATTN: THERESA BROOKS",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20852",
            "telephone_number": "301-816-6660",
            "fax_number": "301-816-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 MERCANTILE LANE",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "20774",
            "telephone_number": "301-618-5578",
            "fax_number": "301-618-5673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "RHONDA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1221 Mercantile Lane",
            "city": "Largo",
            "state": "MD",
            "country_code": "US",
            "postal_code": "20774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

Verify at the official NPI Registry.