Individual provider Active NPI

Robert P. Hennon, M.D.

  • Surgery Physician
  • Bel Air, MD
National Provider Identifier
1629009485
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D0086337 Issued in MD
Practice address
520 Upper Chesapeake Dr Ste 412
Bel Air, MD 21014-4381
Phone
(443) 643-4400
Fax
(443) 643-4404
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X D0086337 MD Primary

Addresses

Primary practice location

520 Upper Chesapeake Dr Ste 412
Bel Air, MD 21014-4381

Mailing address

520 Upper Chesapeake Dr Ste 412
Bel Air, MD 21014-4381
Phone (443) 643-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190131001942 MD Practitioner - General Surgery 7416057997 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0086337MDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Chesapeake Surgical Associates, LLC Surgery CurrentSince Jan 7, 2019 Accepting new patients
Upper Chesapeake Surgical Associates, LLC CurrentSince Jan 7, 2019 Accepting new patients

Locations

520 Upper Chesapeake Dr
Ste 412
Bel Air, MD 21014
Phone (443) 643-4400

500 Upper Chesapeake Dr
Bel Air, MD 21014
Phone (443) 643-1000

515 S Tollgate Rd
Ste 100
Bel Air, MD 21014
Phone (443) 643-3050

421 S Union Ave
Ste 201
Hvre de Grace, MD 21078
Phone (443) 843-6360

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1629009485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 UPPER CHESAPEAKE DR STE 412",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144381",
            "telephone_number": "443-643-4400",
            "fax_number": "443-643-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 UPPER CHESAPEAKE DR STE 412",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144381",
            "telephone_number": "443-643-4400",
            "fax_number": "443-643-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNON",
        "first_name": "ROBERT",
        "middle_name": "P.",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D0086337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.