Breanne Henderson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.006593RX Issued in OH

Practice address

42 Woodcroft TRL
Beavercreek, OH 45430-1995

Phone

(937) 429-0682

NPI assigned

Oct 21, 2020

Last updated

Aug 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: blyon629891@direct.ketteringhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alliance Physicians Inc

  dba Kettering Health Medical Group

  • Family Medicine Physician
  • Kettering, OH
  • NPI 1437125572
  Medicare reassignment NPD
• Kettering Independent Medical Group Inc

  • Orthopaedic Surgery Physician
  • Miamisburg, OH
  • NPI 1629387865
  Medicare reassignment
• The Comprehensive Group of Companies, LLC

  • Internal Medicine Physician
  • Beavercreek, OH
  • NPI 1255869913
  Medicare reassignment
• Alliance Physicians, Inc.

  dba Sleep Disorders Centers-Kettering Health Network

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Beavercreek, OH
  • NPI 1306235114

  Physician Assistant

  NPD
• Comprehensive Medical Services LLC

  • Family Medicine Physician
  • Beachwood, OH
  • NPI 1669486205
  NPD (past)
• PST Services 2000 LLC

  • Internal Medicine Physician
  • Dayton, OH
  • NPI 1477974715
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Miami Valley Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1073688354
  Care Compare affiliation

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1083213946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PRESTIGE PL STE 550",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453426115",
            "telephone_number": "937-762-1310",
            "fax_number": "937-522-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 WOODCROFT TRL",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454301995",
            "telephone_number": "937-429-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "BREANNE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006593RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer F Hedrick, DPT
• Lisa K Heinemeyer-Foster, M.D.
• Rebecca J Helfrich, M.D.
• Helping Hands Massage Therapy, LLC (Elements Massage)
• Chelsea M Hemmelgarn, PTA
• Talieh Hendi, M.D.
• Emily Elizabeth Hendrickson, CPNP
• Katherine Hendrickson, D.O.
• Laura Jean Herbert, FNP-BC
• Abby Hergenrather

• Physician Assistant in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.