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Eden Christian Henry

Pediatrics β€’ Gallup, NM

Active NPI 1114509650 Individual Practitioner Female Practitioner
Practice location in NPPES

516 E Nizhoni Blvd
Gallup, NM 873015748

Call 5057221000 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

516 E Nizhoni Blvd

Gallup, NM 873015748

Telephone 5057221000
Organization at the Same NPPES Address or Phone
Gallup Indian Med Center Pharmacy Facility NPI 1538298989

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2021

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

Years since graduation

5 years (graduated 2021)

CMS Doctors and Clinicians data list 2021 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2021

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

May accept Medicare assignment

CMS data show this clinician may accept Medicare assignment. Clinicians who do not always accept assignment can decide case by case.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Eden Henry has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Eden Henry as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Gallup and New Mexico

21 active clinicians are listed under Pediatrics with a practice address in Gallup, NM (453 in New Mexico).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Gallup

0% of these 21 clinicians have the CMS telehealth indicator.

0% of these 21 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-09-29
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

License # reported to NPPES FL 175086

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

License # reported to NPPES VT 0420017989

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

License # reported to NPPES CO CDR.0005149

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

License # reported to NPPES WY TL8632

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

License # reported to NPPES TX V6597

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: New Mexico State Medical Licensing Board.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PEDIATRIC MEDICINE

Medicare Enrollment ID

I20251205002097

Enrollment State Jurisdiction

FL

PECOS Control ID

6800298522

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

2 listed
NPI 1003590886

Doctor of Optometry

Dr. Angela Dorsey , DO

Family Medicine

NPI 1033308341

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location September 29, 2025

Registered at 516 E NIZHONI BLVD, GALLUP, NM 873015748 (Tel: 5057221000)

πŸ“
Updated Practice Location August 05, 2024

Registered at 121 MEDICAL VILLAGE DR, NEWPORT, VT 058559834 (Tel: 8023345929)

πŸ“
Updated Business Mailing Address August 05, 2024

Registered at 6102 PRIVATE ROAD 6470, LUBBOCK, TX 794163351 (Tel: 8067894871)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 05, 2024

Pediatrics (license number reported to NPPES: VT 0420017989)

βœ…
NPI Profile Active April 23, 2021

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 23, 2021

Registered at 1000 BLYTHE BLVD FL 4, CHARLOTTE, NC 282035812 (Tel: 7043816800)

πŸ“
Business Mailing Address (Initial Record) April 23, 2021

Registered at 1000 BLYTHE BLVD FL 4, CHARLOTTE, NC 282035812 (Tel: 7043816800)

πŸ‘€
Provider Name / Credentials (Initial Record) April 23, 2021

Recorded as EDEN HENRY

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 23, 2021

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration April 23, 2021

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1114509650
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 23, 2021
Last Update: September 29, 2025
Sole Proprietor: No

Mailing Address

6102 Private Road 6470

Lubbock, TX 794163351

Phone: 8067894871

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.