Organization Active NPI

Andrew D. Henry M.D., P.a.

  • Specialist
  • Tampa, FL
National Provider Identifier
1851666523
Registry record updated Mar 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME 79549 Issued in FL
Legal business name
ANDREW D. HENRY M.D., P.A.
Practice address
9270 Bay Plaza Blvd
640
Tampa, FL 33619-4499
Phone
(813) 676-0234
Fax
(813) 676-0237
NPI assigned
Mar 14, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2012

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

Authorized official

Name
Mrs. Gail Davis
Title
Office Manager
Phone
(813) 676-0234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME 79549 FL Primary

Addresses

Primary practice location

9270 Bay Plaza Blvd
640
Tampa, FL 33619-4499

Mailing address

9270 Bay Plaza Blvd
640
Tampa, FL 33619-4499
Phone (813) 676-0234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120321000686 FL Part B Supplier - Clinic/Group Practice 7618137092 Receives reassigned benefits from 1 practitioner
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

9260 Bay Plaza Blvd
Ste 502
Tampa, FL 33619
Phone (813) 676-0234

9270 Bay Plaza Blvd
Ste 640
Tampa, FL 33619
Phone (813) 621-0130

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331683200000",
    "number": "1851666523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9270 BAY PLAZA BLVD",
            "address_2": "640",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336194499",
            "telephone_number": "813-676-0234",
            "fax_number": "813-676-0237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9270 BAY PLAZA BLVD",
            "address_2": "640",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336194499",
            "telephone_number": "813-676-0234",
            "fax_number": "813-676-0237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW D. HENRY M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-14",
        "last_updated": "2012-03-14",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "GAIL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "813-676-0234",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME 79549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.