Individual provider Active NPI

Nancy J Henly, MD

  • Pediatrics Physician
  • Morehead, KY
National Provider Identifier
1730147869
Registry record updated Jun 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
24185 Issued in KY
Practice address
716 W Main St
Morehead, KY 40351-1444
Phone
(606) 780-5364
Fax
(606) 780-2380
NPI assigned
May 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 24185 KY Primary

Addresses

Primary practice location

716 W Main St
Morehead, KY 40351-1444

Mailing address

234 Medical Cir
Morehead, KY 40351-1194
Phone (606) 780-5330

Other identifiers 2

IdentifierTypeStateIssuer
64241854MedicaidKY
24185OtherKYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20110124000376 KY Practitioner - Pediatric Medicine 5496934408 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Black & Carpenter PSC Current Accepting new patients
St Claire Medical Center, Inc CurrentSince Jan 1, 2011 Accepting new patients
St Claire Medical Center, Inc., Current Accepting new patients
St Claire Medical Center, Inc., Pediatrics CurrentSince Jan 1, 2011 Accepting new patients
Sprocket Medical Management LLC Past Accepting new patients
St Claire Medical Center Inc Past Accepting new patients

Locations

234 Medical Cir
Morehead, KY 40351
Phone (606) 784-6641

255 Old Viking Dr
Morehead, KY 40351
Phone (606) 784-2774

245 Flemingsburg Rd
Morehead, KY 40351
Phone (606) 780-5500

716 W Main St
Morehead, KY 40351
Phone (606) 780-5364

222 Medical Cir
Morehead, KY 40351
Phone (606) 783-6455

405 Clinic Dr
Morehead, KY 40351

Organizations & group practices 6

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1730147869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 MEDICAL CIR",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403511194",
            "telephone_number": "606-780-5330",
            "fax_number": "606-780-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 W MAIN ST",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403511444",
            "telephone_number": "606-780-5364",
            "fax_number": "606-780-2380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENLY",
        "first_name": "NANCY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "24185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64241854",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "24185",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead, KY

Sources for this page

Verify at the official NPI Registry.