Raymond Bruce Henthorn, MD

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

License

35048319 Issued in OH

Practice address

316 5TH St
Marietta, OH 45750-3027

Phone

(740) 374-3556

Fax

(740) 374-3577

NPI assigned

Jun 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• R Bruce Henthorn Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Emergency Professional Services, Inc.

  • Emergency Medicine Physician
  • Seaman, OH
  • NPI 1093762353

  Emergency Medical Services

  NPD
• Family Counseling & Rehabilitation Center of Ohio

  • Counselor
  • Marietta, OH
  • NPI 1528605276
  NPD
• Ohio Emergency Professionals Inc

  • Emergency Medicine Physician
  • Columbus, OH
  • NPI 1982983425
  NPD
• Erie Banks Emergency Physicians LLC

  • Emergency Medicine Physician
  • Willoughby, OH
  • NPI 1801105366
  NPD (past)
• Knox Emergency Services, LLC

  • Emergency Medicine Physician
  • Mount Vernon, OH
  • NPI 1861450066
  NPD (past)
• Pfeifer Counseling, Consulting and Training LLC

  • Professional Counselor
  • Williamstown, WV
  • NPI 1841657749
  NPD (past)

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1720083066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 5TH ST",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457503027",
            "telephone_number": "740-374-3556",
            "fax_number": "740-374-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 5TH ST",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457503027",
            "telephone_number": "740-374-3556",
            "fax_number": "740-374-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENTHORN",
        "first_name": "RAYMOND",
        "middle_name": "BRUCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OH",
            "license": "35 048319",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WV",
            "license": "12681",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "OH",
            "license": "35048319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050235000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0539939",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "R",
            "last_name": "HENTHORN",
            "middle_name": "BRUCE",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jonathan Hendrickson, LPN
• Tina Rachelle Henniger, APRN
• John S Henry, MD
• Spring Idale Henry, CDCA
• James Hensel
• Addison Herb
• Justin Curtis Herb, PHARMD
• Madelyn B Hernandez
• Richard G. Herndon, DO
• Jamarcus A Hershberger

• Addiction Medicine (Preventive Medicine) Physician in Marietta, OH
• Providers in Marietta, OH by specialty
• Addiction Medicine (Preventive Medicine) Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.