Robert A. Henry Jr., D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

65243-21 Issued in WI

Practice address

2817 New Pinery Road
Portage, WI 53901-9257

Phone

(608) 742-4131

NPI assigned

Mar 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Divine Savior Healthcare, Inc.

  dba Aspirus Divine Savior Hospital

  • General Acute Care Hospital
  • Portage, WI
  • NPI 1124083894

  Family Medicine

  Medicare reassignment NPD
• Divine Savior Healthcare, Inc.

  dba Aspirus Portage Clinic

  • Rural Health Clinic/Center
  • Portage, WI
  • NPI 1386154417
  NPD

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1740240308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY ROAD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019257",
            "telephone_number": "608-742-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY ROAD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019257",
            "telephone_number": "608-742-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "ROBERT",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H1102",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "65243-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "807629",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010845-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR/MEDICARE",
            "identifier": "080161793",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "1010845-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Robert Hebl, R.PH
• Brian David Heeren, D.C.
• Kristina Hellenbrand, MPT
• Lauren Elizabeth Henderson
• Cynthia Jean Henry, DO
• Heritage House of Portage
• Shauna Michele Heuvelmans, OTR
• Julia Hodkiewicz
• Stephanie Jo Holt, NP
• John Mitchell Hoopes, CRNA

• Family Medicine Physician in Portage, WI
• Providers in Portage, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; 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.