Individual provider Active NPI

Gayle Hennekes, PA

  • Physician Assistant
  • Cincinnati, OH
National Provider Identifier
1407887730
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50000032 Issued in OH
Practice address
2001 Anderson Ferry Rd
Cincinnati, OH 45238-3325
Phone
(513) 922-1200
Fax
(513) 922-2103
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 50000032 OH Primary

Addresses

Primary practice location

2001 Anderson Ferry Rd
Cincinnati, OH 45238-3325

Mailing address

5582 Hoffman Rd
Milford, OH 45150-9717
Phone (513) 575-4236

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050715000612 OH Practitioner - Physician Assistant 3971539453 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50000032OHMDPhysician Assistant

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407887730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5582 HOFFMAN RD",
            "city": "MILFORD",
            "state": "OH",
            "postal_code": "451509717",
            "telephone_number": "513-575-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 ANDERSON FERRY RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452383325",
            "telephone_number": "513-922-1200",
            "fax_number": "513-922-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNEKES",
        "first_name": "GAYLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50000032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.