NPIMap

Individual provider Active NPI

Russell Patrick Henry, M.D.

  • Internal Medicine Physician
  • Houma, LA
National Provider Identifier
1780689893
Registry record updated May 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
012720 Issued in LA
Practice address
911 Verret St
Houma, LA 70360-4637
Phone
(985) 876-7388
Fax
(985) 876-3378
NPI assigned
Jun 15, 2005
Last updated
May 13, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 012720 LA Primary

Addresses

Primary practice location

911 Verret St
Houma, LA 70360-4637

Mailing address

911 Verret St
Houma, LA 70360-4637
Phone (985) 876-7388

Other identifiers 1

IdentifierTypeStateIssuer
1176885MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100819001051 LA Practitioner - Internal Medicine 0840291886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine Clinic of HoumaGroup PAC ID 0042202335, 2 clinicians

Practice addresses (Care Compare)

911 Verret St
Houma, LA 70360-4637
Phone (985) 876-7388

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012720LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Terrebonne Parish Hospital Service District #1 Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273708800000",
    "number": "1780689893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 VERRET ST",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703604637",
            "telephone_number": "985-876-7388",
            "fax_number": "985-876-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 VERRET ST",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703604637",
            "telephone_number": "985-876-7388",
            "fax_number": "985-876-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "RUSSELL",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2010-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "012720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1176885",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

Verify at the official NPI Registry.