Dr. Jerry Tard Henry, DPM
Podiatrist in Las Vegas, NV. Individual provider (NPI-1).
NPI number1477661007
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1477661007
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jerry Tard Henry
- Credential
- DPM
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 25, 2006
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PODIATRY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213E00000X | Podiatrist | 9406 | NV | Yes |
Practice location
341 N. Buffalo DriveSuite A
Las Vegas, NV 89145
Phone 702-242-3870 · Fax 702-242-3873
Mailing address
341 N. Buffalo DriveSuite A
Las Vegas, NV 89145
Phone 702-242-3870 · Fax 702-242-3873
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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