Johanna Hendrickson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5317663-1206 Issued in UT

Practice address

454 E Medical Way
Heber City, UT 84032-1391

Phone

(435) 657-4400

NPI assigned

Jul 29, 2008

Last updated

Aug 12, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Johanna Hastler-Rojas Former name

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in UT, VA, WV, TX4 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 4

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Texas Southwestern Medical Center at DallasGroup PAC ID 0648188250, 3,156 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut of Texas Southwestern University Hospital - William P. Clements Jr. Hospital, Dallas, TX, CCN 450044

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jhendrickson397562@direct.wvuhsdirect.com

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.

• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566
  Medicare reassignment Care Compare group
• Valley Physician Enterprise, Inc

  • Surgery Physician
  • Winchester, VA
  • NPI 1538316203
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment
• Mountain Medical Physician Specialists PC

  • Diagnostic Radiology Physician
  • Murray, UT
  • NPI 1720035520
  Medicare reassignment
• West Virginia University Medical Corporation

  dba University Health Associates

  • Family Medicine Physician
  • Morgantown, WV
  • NPI 1275504508
  Medicare reassignment
• Winchester Medical Center

  dba Valley Intensivists

  • Critical Care Medicine (Internal Medicine) Physician
  • Winchester, VA
  • NPI 1679711261
  Medicare reassignment
• Ihc Health Services Inc

  dba McKay Dee Dermatology & Plastic Surgery

  • Dermatology Physician
  • Ogden, UT
  • NPI 1487966768
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Shenandoah Valley Pathology Laboratories Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Winchester, VA
  • NPI 1447363114
  NPD
• The University of Texas Southwestern Medical Center at Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1396832713
  NPD
• University of Texas Southwestern Medical Center at Dallas

  • Vascular Surgery Physician
  • Dallas, TX
  • NPI 1134173966
  NPD
• Valley Physician Enterprise, Inc.

  dba Valley Health Fertility

  • Obstetrics & Gynecology Physician
  • Winchester, VA
  • NPI 1255222535
  NPD

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

• University of Texas Southwestern Medical Center at Dallas

  dba UT Southwestern University Hospital

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1285798918
  Care Compare affiliation

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1447416516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CAMPUS BLVD STE 100",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012896",
            "telephone_number": "540-536-5100",
            "fax_number": "540-536-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 E MEDICAL WAY",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840321391",
            "telephone_number": "435-657-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1840 Amherst St",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226012808",
            "country_code": "US",
            "telephone_number": "540-536-8000",
            "fax_number": "540-536-7780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Campus Blvd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226016906",
            "country_code": "US",
            "telephone_number": "540-536-3470",
            "fax_number": "540-536-3471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "JOHANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110007662",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "5317663-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhendrickson793806@soc.inova.org",
            "affiliation": "N",
            "address_1": "400 Campus Blvd Ste 210",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226016906",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhendrickson793806@soc.inova.org",
            "affiliation": "N",
            "address_1": "1840 Amherst St",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226012808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "johanna.hendrickson@direct.imail.org",
            "affiliation": "N",
            "address_1": "454 E Medical Way",
            "city": "Heber City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840321391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JOHANNA",
            "last_name": "HASTLER-ROJAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heber Valley Internal Medicine
• Heber Valley Medical LLC
• Heber Valley Oral & Maxillofacial Surgery
• Heber Valley Pediatric
• Heber Valley Physical Therapy Inc
• Scott Curtis Hendrickson, DO
• Marci Heugly
• Hidden Piece Counseling LLC
• Kayleigh Hofheins
• Joy Holbrook, APRN

• Physician Assistant in Heber City, UT
• Providers in Heber City, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.