John C. Henry, M.D., P.a.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

83-218 Issued in NM

Legal business name

JOHN C. HENRY, M.D., P.A.

Practice address

207 N Union Ave
Suite C
Roswell, NM 88201-3068

Phone

(575) 624-2330

Fax

(575) 622-9133

NPI assigned

Oct 5, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Glenda F Henry

Title

Office Manager

Phone

(575) 624-2330

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Richard J Sidd, MD

  • Ophthalmology Physician
  • Roswell, NM
  • NPI 1205998788
  NPD (past)

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

{
    "created_epoch": "1223164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223164800000",
    "number": "1881845170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N UNION AVE",
            "address_2": "SUITE C",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013068",
            "telephone_number": "575-624-2330",
            "fax_number": "575-622-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 N UNION AVE",
            "address_2": "SUITE C",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013068",
            "telephone_number": "575-624-2330",
            "fax_number": "575-622-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C. HENRY, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-05",
        "last_updated": "2008-10-05",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "575-624-2330",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NM",
            "license": "83-218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25239",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melinda Jenson-Klein
• Amanda Jerge, MOTR/L
• Weitian Jiang
• Araceli Jimenez Avelar
• Julie Jimenez
• Caren Sue Johnson, RN
• Heather Marie Johnson, LMHC-T
• Kathleen M. Johnson, M.S. CCC-SLP
• Max Snitker Johnson, OD
• Stephanie Johnson, HAD

• Dermatology Physician in Roswell, NM
• Providers in Roswell, NM by specialty
• Dermatology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.