Edward C Hennis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD485353 Issued in PA

Practice address

1135 Lake St Ste 2
Girard, PA 16417-1049

Phone

(814) 774-3155

Fax

(814) 456-2375

NPI assigned

Apr 5, 2020

Last updated

Jul 14, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Family Practice

Education

Howard University College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health NetGroup PAC ID 1759290588, 16 clinicians

Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Vincent Hospital Hospital, Erie, PA, CCN 390009

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edward.hennis.p1@direct.communityhealthnet.nextgenshare.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.

• Community Health Net

  • Federally Qualified Health Center (FQHC)
  • Erie, PA
  • NPI 1245209170
  Medicare reassignment Care Compare group NPD
• Community Health Net

  • Federally Qualified Health Center (FQHC)
  • Harborcreek, PA
  • NPI 1336301092
  NPD
• Community Health Net

  • Federally Qualified Health Center (FQHC)
  • Girard, PA
  • NPI 1992185458
  NPD
• Community Health Net

  • Federally Qualified Health Center (FQHC)
  • Erie, PA
  • NPI 1831484922
  NPD (past)
• Community Health Net

  • Federally Qualified Health Center (FQHC)
  • Erie, PA
  • NPI 1972826626
  NPD (past)

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

• Saint Vincent Health Center

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1861435042
  Care Compare affiliation

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

{
    "created_epoch": "1586044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1639708308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165011914",
            "telephone_number": "814-454-4530",
            "fax_number": "814-456-2375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 LAKE ST STE 2",
            "city": "GIRARD",
            "state": "PA",
            "postal_code": "164171049",
            "telephone_number": "814-774-3155",
            "fax_number": "814-456-2375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1202 State St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165011914",
            "country_code": "US",
            "telephone_number": "814-455-7222",
            "fax_number": "814-456-2375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNIS",
        "first_name": "EDWARD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-05",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD485353",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD485353",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Jean Godzac, O.D.
• Greater Erie Community Action Committee (GECAC D&A Services)
• Sheila Hamilton, RPH
• Brian Patrick Harvey, RPH
• Desiree Nicole Hawkins, CRNP
• Alyson Jaworski, DPT
• Jon Keep, RN
• Kyle Kelley
• Susanne Marie Kelly, LPN
• Keystone Rehabilitation Systems Inc (Keystone Physical Therapy)

• Family Medicine Physician in Girard, PA
• Providers in Girard, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.