NPIMap

Individual provider Active NPI

Wesley Dubois Henry, MD

  • Diagnostic Radiology Physician
  • Charleston, SC
National Provider Identifier
1831174978
Registry record updated Feb 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
12450 Issued in SC
Practice address
316 Calhoun St
Charleston, SC 29401
Phone
(843) 724-2988
Fax
(843) 805-6277
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 12450 SC Primary

Addresses

Primary practice location

316 Calhoun St
Charleston, SC 29401

Mailing address

PO Box 2363
Indianapolis, IN 46206-2363
Phone (843) 724-2988

Other identifiers 2

IdentifierTypeStateIssuer
300042053OtherSCRR MEDICARE
124500MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20050607000987 SC Practitioner - Diagnostic Radiology 3173566429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical University of South Carolina College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roper Radiologists PAGroup PAC ID 6800700162, 40 clinicians

Practice addresses (Care Compare)

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-1783

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Radiologists PA Diagnostic Radiology CurrentSince Aug 1, 1993 Accepting new patients
Roper Hospital Inc. PastSince Aug 1, 1993 Accepting new patients
James Island Physical Therapy Past Accepting new patients

Locations

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

2085 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 577-6957

3 S Park Cir
Ste 240
Charleston, SC 29407

333 Folly Rd
Charleston, SC 29412
Phone (843) 406-9889

2085 Henry Tecklenburg Dr
Ste 105
Charleston, SC 29414
Phone (843) 724-2154

125 Doughty St
Charleston, SC 29403
Phone (843) 724-2086

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

Organizations & group practices 3

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 10

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1831174978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2363",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462062363",
            "telephone_number": "843-724-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 CALHOUN ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29401",
            "telephone_number": "843-724-2988",
            "fax_number": "843-805-6277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "WESLEY",
        "middle_name": "DUBOIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "12450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "300042053",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124500",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.