Gordon W Hendrickson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1447 Issued in WY

Practice address

528 Coffeen Ave
Sheridan, WY 82801-5312

Phone

(307) 683-7138

NPI assigned

Nov 14, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kirkpatrick Family Care, PSGroup PAC ID 3375536436, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth St John Medical Center Hospital, Longview, WA, CCN 500041

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Kirkpatrick Family Care, PS

  • Medical Specialty Clinic/Center
  • Longview, WA
  • NPI 1447286646
  Medicare reassignment Care Compare group
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  WA

  Medicare reassignment
• Wyoming Clinic of Medicine, LLC

  • Medical Physician Assistant
  • Sheridan, WY
  • NPI 1306769096
  NPD (past) Authorized official
• Kirkpatrick Family Care, PS

  dba Kirkpatrick Family Care Foot & Ankle

  • Podiatrist
  • Longview, WA
  • NPI 1952746026
  NPD

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

• Peacehealth

  dba St. John Medical Center

  • General Acute Care Hospital
  • Longview, WA
  • NPI 1073510277
  Care Compare affiliation

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1538877071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 COFFEEN AVE",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828015312",
            "telephone_number": "307-683-7138",
            "fax_number": "307-655-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 COFFEEN AVE",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828015312",
            "telephone_number": "307-683-7138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1706 Washington Way",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986322952",
            "country_code": "US",
            "telephone_number": "604-239-5803",
            "fax_number": "360-423-6230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDRICKSON",
        "first_name": "GORDON",
        "middle_name": "W",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-14",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "PA1447",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61369633",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Dave Hellekson, M.D.
• Myranda Helpingstine, MS
• Hematology Oncology Centers of the Northern Rockies PC
• Brenda Lee Henderson, BACHELOR OF ARTS DEG
• Erin Marie Henderson, M.D.
• Morgan Hendrickson
• Kristina Marie Hernandez McDougall
• Jenny M Heuck, PMHNP
• HH Virtuahealth
• Maureen Jane Hickey

• Physician Assistant in Sheridan, WY
• Providers in Sheridan, WY by specialty
• Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; 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.