Active NPI
James Hennessy, PA-C
- Physician Assistant
- Scottsdale, AZ
National Provider Identifier
1801525241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9186
- Practice address
- 8705 E McDowell Rd
Scottsdale, AZ 85257-3909 - Phone
- (480) 882-4545
- Fax
- (480) 405-8929
- NPI assigned
- Jun 9, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 9186 | AZ | Primary |
Addresses
Primary practice location
8705 E McDowell Rd
Scottsdale, AZ 85257-3909
Mailing address
907 Kemper Dr
Mansfield, TX 76063-3708
Phone (619) 905-6330
Other practice location 1
312 N Alma School Rd Ste 11
Chandler, AZ 85224-4354
Phone (623) 300-5447
Other practice location 2
1030 E Florida Ave
Hemet, CA 92543-4511
Phone (833) 867-4642
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 163742 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Coppell, TX
- NPI 1255922944
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713139200000",
"number": "1801525241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "907 KEMPER DR",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760633708",
"telephone_number": "619-905-6330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8705 E MCDOWELL RD",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852573909",
"telephone_number": "480-882-4545",
"fax_number": "480-405-8929"
}
],
"practiceLocations": [
{
"address_1": "312 N Alma School Rd Ste 11",
"address_purpose": "LOCATION",
"city": "Chandler",
"state": "AZ",
"postal_code": "852244354",
"country_code": "US",
"telephone_number": "623-300-5447",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1030 E Florida Ave",
"address_purpose": "LOCATION",
"city": "Hemet",
"state": "CA",
"postal_code": "925434511",
"country_code": "US",
"telephone_number": "833-867-4642",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HENNESSY",
"first_name": "JAMES",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-06-09",
"last_updated": "2024-04-15",
"certification_date": "2024-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": "AZ",
"license": "9186",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "163742",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.