Individual provider Active NPI

Mark Richard Henry, M.D.

  • Family Medicine Physician
  • Dallastown, PA
National Provider Identifier
1659302081
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD053319L Issued in PA
Practice address
755 S Pleasant Ave
Dallastown, PA 17313-9252
Phone
(717) 851-1300
Fax
(717) 851-1310
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD053319L PA Primary

Addresses

Primary practice location

755 S Pleasant Ave
Dallastown, PA 17313-9252

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 851-1300

Other practice location 1

105 Fourth Street
East Berlin, PA 17316
Phone (717) 812-4900

Other identifiers 11

IdentifierTypeStateIssuer
1142348OtherPAAMERIHEALTH MERCY-WMG
80745OtherPAUNISON-WMG
001516352MedicaidPA
233496OtherPAMAMSI-WMG
542992OtherMDCAREFIRST MD BCBS
681097OtherPAHIGHMARK BLUE SHIELD
5898005OtherPAAETNA
1060701OtherPACAPITAL BLUE CROSS-WMG
39761OtherPAGEISINGER
30032OtherPAJOHNS HOPKINS
P002800OtherPAGATEWAY-WMG

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1001 S George St
York, PA 17403
Phone (717) 812-7687

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

1803 Mount Rose Ave
Ste B3
York, PA 17403
Phone (717) 851-6816

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1659302081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-851-1300",
            "fax_number": "717-851-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S PLEASANT AVE",
            "city": "DALLASTOWN",
            "state": "PA",
            "postal_code": "173139252",
            "telephone_number": "717-851-1300",
            "fax_number": "717-851-1310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Fourth Street",
            "address_purpose": "LOCATION",
            "city": "East Berlin",
            "state": "PA",
            "postal_code": "17316",
            "country_code": "US",
            "telephone_number": "717-812-4900",
            "fax_number": "717-259-7262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRY",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD053319L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY-WMG",
            "identifier": "1142348",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON-WMG",
            "identifier": "80745",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001516352",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI-WMG",
            "identifier": "233496",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD BCBS",
            "identifier": "542992",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "681097",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5898005",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS-WMG",
            "identifier": "1060701",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "39761",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHNS HOPKINS",
            "identifier": "30032",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY-WMG",
            "identifier": "P002800",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallastown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.