Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ian Jacob Henry

Individual provider Physician Assistant · NPI 1043971047

Ian Jacob Henry is a Physician Assistant in Reston, Virginia. Qualified in 2021, 5 years ago. Practices with Intensive Care Consortium Inc, a 483-clinician group and accepts Medicare assignment.

Years since qualifying
5
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

1850 Town Center Pkwy
Reston, VA 20190-3298
Phone: (703) 689-9000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1043971047
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 3, 2022
Last updated in NPPESJune 24, 2022
Certification dateJune 24, 2022
Mailing address127 Fort Evans Rd Se Apt A, Leesburg, VA 20175-4142

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Intensive Care Consortium Inc — 483 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Reston