Individual provider Active NPI

Gary Lee Hensley-Laird, M.D.

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1912917501
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME122861 Issued in FL
Practice address
2810 W Saint Isabel St Ste 201
Tampa, FL 33607-6375
Phone
(813) 890-8004
Fax
(813) 290-9691
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 022276 LA
Internal Medicine Physician 207R00000X ME122861 FL Primary

Addresses

Primary practice location

2810 W Saint Isabel St Ste 201
Tampa, FL 33607-6375

Mailing address

6545 Corporate Centre Blvd
Orlando, FL 32822-3253
Phone (855) 893-2298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150731014296 FL Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 4981668035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospice/Palliative Care
Education
Louisiana State University School of Medicine in Shreveport, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Medical Management of Florida IncGroup PAC ID 3971678558, 158 clinicians

Practice addresses (Care Compare)

2155 SE Federal Hwy
Wellmed at South Stuart
Stuart, FL 34994-4514
Phone (772) 223-9630

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
022276LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Management of Florida Inc CurrentSince Jan 1, 2021 Accepting new patients
Gulfside Hospice, Inc. Past Accepting new patients

Locations

6545 Corporate Centre Blvd
Orlando, FL 32822

2155 SE Federal Hwy
Stuart, FL 34994
Phone (772) 223-9630

Interoperability endpoints

  • Direct secure messaging: gary.hensleylaird@wellmed.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1912917501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 CORPORATE CENTRE BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328223253",
            "telephone_number": "855-893-2298",
            "fax_number": "866-214-6824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 W SAINT ISABEL ST STE 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076375",
            "telephone_number": "813-890-8004",
            "fax_number": "813-290-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSLEY-LAIRD",
        "first_name": "GARY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "022276",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME122861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.