Kelsey Violet Henry, MS, ATC, LAT, CES

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT003265 Issued in GA

Practice address

6000 N Terminal Pkwy
Atlanta, GA 30320-7400

Phone

(404) 773-7480

NPI assigned

Mar 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Premise Health of Georgia Medical, P.C.

  • Multi-Specialty Clinic/Center
  • Atlanta, GA
  • NPI 1295584654
  NPD (past)

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1659873370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2931 PANTHERSVILLE RD APT D115",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300343025",
            "telephone_number": "417-342-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 N TERMINAL PKWY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303207400",
            "telephone_number": "404-773-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "KELSEY",
        "middle_name": "VIOLET",
        "credential": "MS, ATC, LAT, CES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT003265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaushai Henry
• Jessica Henry, PHD
• John D Henry Jr., MD
• Katherine Henry, CNS
• Keisha Marie Henry, WLS, CWC
• Kierra Henry, CAA
• Lydia Althea Henry, CCC-SLP
• Mary Katherine Henry
• Mary Lisa Henry, PH. D., LCSW
• Rhonesia Henry

• Athletic Trainer in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.