Individual provider Active NPI

Heather M Henning, PA-C

  • Physician Assistant
  • Pahala, HI
National Provider Identifier
1356060941
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AMD-1353 Issued in HI
Practice address
1 Kamani St
Pahala, HI 96777
Phone
(920) 209-3602
NPI assigned
Aug 25, 2022
Last updated
Jan 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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 AMD-1353 HI Primary

Addresses

Primary practice location

1 Kamani St
Pahala, HI 96777

Mailing address

PO Box 1064
Volcano, HI 96785-1064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20240328001232 HI Practitioner - Physician Assistant 7517304355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kau HospitalGroup PAC ID 7416945548, 138 clinicians

Practice addresses (Care Compare)

1 Kamani St
Pahala, HI 96777
Phone (808) 932-4370

15 -2622 Paho Village Rd
Suite 303
Pahoa, HI 96778-7716
Phone (808) 932-3940

15 -2714 Pahoa Village Rd
Suite 5
Pahoa, HI 96778-9715
Phone (808) 930-6001

16 -523 Keaau Pahoa Rd
Keaau, HI 96749-8156
Phone (808) 932-3830

PO Box
Suite 40
Pahala, HI 96777

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kau Hospital CurrentSince Mar 14, 2024 Accepting new patients
Kau Hospital CurrentSince Mar 14, 2024 Accepting new patients

Locations

16-523 Keaau Pahoa Rd
Keaau, HI 96749
Phone (808) 932-3801

15-2714 Pahoa Village Rd
Unit L5
Pahoa, HI 96778
Phone (808) 729-9090

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1356060941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1064",
            "city": "VOLCANO",
            "state": "HI",
            "postal_code": "967851064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KAMANI ST",
            "city": "PAHALA",
            "state": "HI",
            "postal_code": "96777",
            "telephone_number": "920-209-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNING",
        "first_name": "HEATHER",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD-1353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pahala, HI

Sources for this page

Verify at the official NPI Registry.