Individual provider Active NPI

Keith Anthony Henry, M.D.

  • Hospitalist Physician
  • Winston Salem, NC
National Provider Identifier
1770017543
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2020-02868 Issued in NC
Practice address
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone
(336) 718-8383
Fax
(336) 718-9622
NPI assigned
Apr 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2020-02868 NC Primary

Addresses

Primary practice location

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (336) 718-8383

Other practice location 1

1 Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-4490

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address khenry819475@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20200728001227 NC Practitioner - Internal Medicine 7911270525 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wake Forest University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1010 Bethesda CT
Winston Salem, NC 27103-3019
Phone (336) 277-6000

Hospital & facility affiliations

  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020-02868NCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Jul 1, 2020 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Sep 16, 2024 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Sep 16, 2024 Accepting new patients
Novant Medical Group, Inc CurrentSince Jul 1, 2020 Accepting new patients

Locations

6915 Village Medical Cir
Clemmons, NC 27012
Phone (336) 718-1680

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

1010 Bethesda Ct
Winston Salem, NC 27103
Phone (336) 277-6000

Interoperability endpoints

  • Direct secure messaging: khenry819475@direct.novanthealth.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1770017543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-718-8383",
            "fax_number": "336-718-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-718-8383",
            "fax_number": "336-718-9622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271570001",
            "country_code": "US",
            "telephone_number": "336-716-4490",
            "fax_number": "336-716-7359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRY",
        "first_name": "KEITH",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-18",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2020-02868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khenry819475@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1 Medical Center Blvd",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271570001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.