Gretchen Hennegan, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

COA.15113-NP Issued in OH

Practice address

25000 Country Club Blvd
Suite 255
North Olmsted, OH 44070-5344

Phone

(440) 793-2255

Fax

(440) 793-7194

NPI assigned

Oct 16, 2013

Last updated

Oct 16, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381881600000",
    "number": "1821426453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25000 COUNTRY CLUB BLVD",
            "address_2": "SUITE 255",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440705344",
            "telephone_number": "440-793-2255",
            "fax_number": "440-793-7194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25000 COUNTRY CLUB BLVD",
            "address_2": "SUITE 255",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440705344",
            "telephone_number": "440-793-2255",
            "fax_number": "440-793-7194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNEGAN",
        "first_name": "GRETCHEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-16",
        "last_updated": "2013-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OH",
            "license": "COA.15113-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kelsey Bernadette Hester
• Holly Marie Higgs, PSY.D.
• Kara Marie Hodge, SLP
• Lisa Marie Hollo, MA ATR LPCC-S
• Hollowell Counseling LLC

• Gerontology Nurse Practitioner in North Olmsted, OH
• Providers in North Olmsted, OH by specialty
• Gerontology Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; 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.

Verify at the official NPI Registry.