Henry Lee McKay, MD
Individual provider Active NPI Internal Medicine Physician · Stockbridge, GA
NPI 1871657569 · NPPES record last updated Nov 1, 2016
Key facts
- NPI
- 1871657569
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 054300 (GA)
- Practice address
- 175 Country Club Dr
BLDG 100D
Stockbridge, GA 30281-7380 - Phone
- (678) 271-2833
- Fax
- (678) 271-2834
- NPI assigned
- Dec 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160816001960 | GA | Practitioner - Internal Medicine | 5294711651 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054300 | GA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smithville Emergency Services, LLC | Past | Accepting new patients | |
| Southeastern Physician Services PC | Internal Medicine | Past | Accepting new patients |
| United Emergency Services, Inc. | Past | Accepting new patients | |
| McMinnville Emergency Services LLC | Past | Accepting new patients | |
| Hospitalists of Jackson LLC | Internal Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 054300 | GA | Yes |
Addresses
Primary practice location
175 Country Club Dr
BLDG 100D
Stockbridge, GA 30281-7380
Mailing address
175 Country Club Dr
BLDG 100D
Stockbridge, GA 30281-7380
Phone (678) 271-2833
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52704229001 | Other | GA | BCBS - GA |
| 645081720A | Medicaid | GA |
Other providers in Stockbridge, GA
- Katherine Ann McFarlin
- Jeffery Ray McGee
- Kavin K McGee
- Chanea McGhaney-Isom
- Kimberly Jaye McIntosh
- Rachel Ayers McKay
- Denise McKinley
- McKinney Surgical Services
- Jackey S McKinney
- Michael Lee McKinney Jr.
All providers in Stockbridge, GA · Internal Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.