Individual provider Active NPI

Emily M Hennes, P.A.

  • Medical Physician Assistant
  • Independence, MO
National Provider Identifier
1730415597
Registry record updated Oct 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PENDING Issued in MO
Practice address
19550 E 39TH St S
Ste 410
Independence, MO 64057-2303
Phone
(816) 303-2400
Fax
(816) 303-2484
NPI assigned
Oct 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PENDING MO Primary
Surgical Physician Assistant 363AS0400X PENDING MO

Addresses

Primary practice location

19550 E 39TH St S
Ste 410
Independence, MO 64057-2303

Mailing address

2790 Clay Edwards Dr
Ste 600
Kansas City, MO 64116-3276
Phone (816) 561-3003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20100108000469 MO Practitioner - Physician Assistant 1456492743 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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": "1256688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256688000000",
    "number": "1730415597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR",
            "address_2": "STE 600",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641163276",
            "telephone_number": "816-561-3003",
            "fax_number": "816-889-1584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19550 E 39TH ST S",
            "address_2": "STE 410",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572303",
            "telephone_number": "816-303-2400",
            "fax_number": "816-303-2484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNES",
        "first_name": "EMILY",
        "middle_name": "M",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-28",
        "last_updated": "2009-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "PENDING",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "PENDING",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.