Individual provider Active NPI

Tracey Lynn Henry

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1710279955
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
75124 Issued in GA
Practice address
49 Jesse Hill Jr Dr SE
Fob Suite 483
Atlanta, GA 30303-3049
Phone
(404) 251-8908
NPI assigned
May 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 390200000XL LA
Internal Medicine Physician 207R00000X 042583 DC
Internal Medicine Physician 207R00000X 206179 LA
Internal Medicine Physician 207R00000X 75124 GA Primary

Addresses

Primary practice location

49 Jesse Hill Jr Dr SE
Fob Suite 483
Atlanta, GA 30303-3049

Mailing address

49 Jesse Hill Jr Dr SE
Fob Suite 483
Atlanta, GA 30303-3049
Phone (404) 251-8908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160726003240 GA Practitioner - Internal Medicine 9537380183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.24 of 100Reported as group
Quality
73.72
Promoting interoperability
100
Improvement activities
40
Cost
75.22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042583DCMDInternal Medicine Physician
75124GAMDInternal Medicine Physician
206179LAMDInternal Medicine Physician
390200000XLLAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Internal Medicine Current Accepting new patients
Emory Medical Care Foundation Inc Internal Medicine CurrentSince May 21, 2016 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince May 21, 2016 Accepting new patients
Emory Medical Care Foundation Inc Past Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

49 Jesse Hill Jr Dr SE
Ste 483
Atlanta, GA 30303
Phone (404) 251-8908

80 Butler St SE
Atlanta, GA 30368
Phone (404) 327-5920

101 W Ponce de Leon Ave
Ste 350
Decatur, GA 30030

Organizations & group practices 4

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": "1304640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1710279955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 JESSE HILL JR DR SE",
            "address_2": "FOB SUITE 483",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033049",
            "telephone_number": "404-251-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 JESSE HILL JR DR SE",
            "address_2": "FOB SUITE 483",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033049",
            "telephone_number": "404-251-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "TRACEY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-06",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "390200000XL",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "042583",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "206179",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "75124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.