Individual provider Active NPI

Megan Q Hennings, PA-C

  • Physician Assistant
  • Emeryville, CA
National Provider Identifier
1497064166
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-003844 Issued in IL
Practice address
2100 Powell St
Suite 920
Emeryville, CA 94608-1826
Phone
(888) 267-3880
Fax
(510) 879-9100
NPI assigned
Sep 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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 085-003844 IL Primary

Addresses

Primary practice location

2100 Powell St
Suite 920
Emeryville, CA 94608-1826

Mailing address

2100 Powell St
Suite 920
Emeryville, CA 94608-1826
Phone (888) 267-3880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085-003844ILMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1497064166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 920",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "888-267-3880",
            "fax_number": "510-879-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 920",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "888-267-3880",
            "fax_number": "510-879-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNINGS",
        "first_name": "MEGAN",
        "middle_name": "Q",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-29",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-003844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emeryville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.