Craig Damon Henry, MSN, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

903338 Issued in MS

Practice address

1824 Hospital Dr
Jackson, MS 39204-3410

Phone

(601) 346-4586

Fax

(601) 346-4587

NPI assigned

Dec 19, 2019

Last updated

Dec 19, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 11

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Ripley, MS
  • NPI 1447769559

  Family

  Medicare reassignment Care Compare group NPD
• Family Health Care Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pearl, MS
  • NPI 1043236326
  Medicare reassignment NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  MS

  Medicare reassignment NPD
• Magnolia Premier Medical Group PLLC

  • Family Medicine Physician
  • Ridgeland, MS
  • NPI 1164293387
  Authorized official Same address or phone
• Pulse, LLC

  • Medical-Surgical Registered Nurse
  • Byram, MS
  • NPI 1669788345

  Continuing Education/Staff Development

  NPD (past) Authorized official
• Family Health Care Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bude, MS
  • NPI 1104059146
  NPD
• Family Health Care Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Flowood, MS
  • NPI 1689440133
  NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Kosciusko, MS
  • NPI 1851050579
  NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Ocoee, FL
  • NPI 1326906843
  NPD
• Jackson Pediatric Associates

  • Specialist
  • Ridgeland, MS
  • NPI 1457484594
  NPD (past)
• Jackson Pediatric Associates P a

  dba Chadwick Drive Clinic

  • Specialist
  • Jackson, MS
  • NPI 1659556298
  NPD (past)

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1639717713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 CRESTON DR",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392723003",
            "telephone_number": "601-613-5681",
            "fax_number": "601-372-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 HOSPITAL DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043410",
            "telephone_number": "601-346-4586",
            "fax_number": "601-346-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "CRAIG",
        "middle_name": "DAMON",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-19",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "MS",
            "license": "903338",
            "primary": false
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "MS",
            "license": "903338",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "MS",
            "license": "903338",
            "primary": false
        },
        {
            "code": "163WN1003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nutrition Support",
            "state": "MS",
            "license": "903338",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "MS",
            "license": "903338",
            "primary": false
        },
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "MS",
            "license": "903338",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MS",
            "license": "903338",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MS",
            "license": "903338",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MS",
            "license": "903338",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MS",
            "license": "903338",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Clark Henegan Jr., M.D.
• Aftan Henley, PHARMD
• Jennifer Henley, FNP-C
• Brian Allen Henry, LPTA
• Cinder Henry
• David Chan Henry, MD
• Elizabeth Castleberry Henry, CRNFA
• Shasa Rene Henry, RPSGT
• William David Henry, DMD, PT
• William Ryan Henry, MD

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.

Verify at the official NPI Registry.