Individual provider Active NPI

Amanda Jo Henning, MSN, NP-C

  • Gerontology Nurse Practitioner
  • Kearny, NJ
National Provider Identifier
1215456983
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ00760500 Issued in NJ
Practice address
175 Belgrade Dr.
Kearny, NJ 07032
Phone
(908) 809-9130
NPI assigned
Sep 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ00760500 NJ Primary
Primary Care Nurse Practitioner 363LP2300X 26NJ00760500 NJ
Nurse Practitioner 363L00000X 26NJ00760500 NJ
Adult Health Nurse Practitioner 363LA2200X 26NJ00760500 NJ

Addresses

Primary practice location

175 Belgrade Dr.
Kearny, NJ 07032

Mailing address

175 Belgrade Dr.
Kearny, NJ 07032

Other identifiers 1

IdentifierTypeStateIssuer
26NJ00760500OtherNJSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20180126002094 NJ Practitioner - Nurse Practitioner 3375803075 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00760500NJMDGerontology Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: ms_ahennin8@landmarkhealth-direct.org

Organizations & group practices 1

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": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1215456983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 BELGRADE DR.",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "07032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 BELGRADE DR.",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "07032",
            "telephone_number": "908-809-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNING",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "credential": "MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00760500",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ00760500",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00760500",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00760500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "26NJ00760500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearny, NJ

Sources for this page

Verify at the official NPI Registry.