Individual provider Active NPI

Johanna Sofia Vonhagn, PA-C

  • Physician Assistant
  • Hampstead, MD
National Provider Identifier
1316433915
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2327 Hanover Pike
Hampstead, MD 21074-1150
Phone
(443) 507-6035
Fax
(443) 507-6953
NPI assigned
Jul 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2327 Hanover Pike
Hampstead, MD 21074-1150

Mailing address

2327 Hanover Pike
Hampstead, MD 21074-1150
Phone (443) 507-6035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190109001057 MD Practitioner - Physician Assistant 9335492941 Reassigns benefits to 1 organization
I20190114000107 DC Practitioner - Physician Assistant 9335492941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MNR Industries, LLCGroup PAC ID 7416908843, 142 clinicians

Practice addresses (Care Compare)

1505 E Churchville Rd
Bel Air, MD 21014-4742

2327 Hanover Pike
Hampstead, MD 21074-1150
Phone (410) 848-3990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MNR Industries LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Dec 1, 2018 Accepting new patients
MNR Industries, LLC CurrentSince Dec 1, 2018 Accepting new patients
MNR Industries, LLC CurrentSince Dec 1, 2018 Accepting new patients

Locations

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

1505 E Churchville Rd
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

2327 Hanover Pike
Hampstead, MD 21074
Phone (410) 848-3990

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1316433915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2327 HANOVER PIKE",
            "city": "HAMPSTEAD",
            "state": "MD",
            "postal_code": "210741150",
            "telephone_number": "443-507-6035",
            "fax_number": "443-507-6953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2327 HANOVER PIKE",
            "city": "HAMPSTEAD",
            "state": "MD",
            "postal_code": "210741150",
            "telephone_number": "443-507-6035",
            "fax_number": "443-507-6953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONHAGN",
        "first_name": "JOHANNA",
        "middle_name": "SOFIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampstead, MD

Sources for this page

Verify at the official NPI Registry.