Metro Providers, PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

33009 Issued in KY

Legal business name

METRO PROVIDERS, PLLC

Doing business as

Dynamic Medical & Rehab

Practice address

3707 Chamberlain LN
Suite 101
Louisville, KY 40241-2001

Phone

(502) 426-9200

Fax

(502) 426-9259

NPI assigned

Jul 21, 2008

Last updated

Sep 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark T Henderson, MDNPI 1255372868

Title

Owner

Phone

(502) 426-9200

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dynamic Medical & Rehab Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark T Henderson, MD

  • Emergency Medicine Physician
  • Louisville, KY
  • NPI 1255372868
  NPD (past) Authorized official

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1811152713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 CHAMBERLAIN LN",
            "address_2": "SUITE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412001",
            "telephone_number": "502-426-9200",
            "fax_number": "502-426-9259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 CHAMBERLAIN LN",
            "address_2": "SUITE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412001",
            "telephone_number": "502-426-9200",
            "fax_number": "502-426-9259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO PROVIDERS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-21",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-426-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4390",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "KY",
            "license": "33009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64330095",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynamic Medical & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Jo Metrick, ARNP MSN
• Metro Dental Group, PLLC.
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• Metro Louisville Endodontics,LLC
• Metro Pediatric Associates PLLC
• Metro Urgent Care at Dixie, LLC (Metro Urgent Care LLC)
• Metro Urgent Care PLLC
• Metropolitan Ankle and Foot Center Inc
• Metropolitan Foot & Ankle PLLC
• Catherine A Metry, DVM

• General Practice Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.