Karla May Hennequin, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

103066 Issued in NC

Practice address

3345 39TH St S
Fargo, ND 58104-7539

Phone

(877) 522-1275

NPI assigned

Nov 30, 2005

Last updated

Mar 6, 2025By 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MT, WA, NM, ND, AK, MD, TN, ID, OR9 enrollments

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 9

Specialty

Physician Assistant

Education

Wake Forest University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ideal Telemedicine Services LLCGroup PAC ID 2860726221, 47 clinicians

Ideal Option PLLCGroup PAC ID 6709013105, 90 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Ideal Option, PLLC

  • Clinic/Center
  • Kennewick, WA
  • NPI 1457788275

  AK, ID, MD, MT, ND, NM, OR, TN

  Medicare reassignment Care Compare group
• Ideal Telemedicine Services, LLC

  • Clinic/Center
  • Renton, WA
  • NPI 1346754868

  AK, ID, MD, MT, ND, NM, OR, TN

  Medicare reassignment Care Compare group
• Peak Health & Wellness, LLC

  dba BestMed

  • Urgent Care Clinic/Center
  • Belgrade, MT
  • NPI 1073669461
  Medicare reassignment
• Ideal Option, PLLC

  • Clinical Medical Laboratory
  • Kennewick, WA
  • NPI 1841648623
  NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)
• Ideal Telemedicine Services, LLC

  • Clinic/Center
  • Rosedale, MD
  • NPI 1427561828
  NPD (past)
• Ideal Telemedicine Services, LLC

  • Clinic/Center
  • Billings, MT
  • NPI 1982148607
  NPD (past)
• Peak Health and Wellness, PLLC

  dba Nova Health

  • Urgent Care Clinic/Center
  • Belgrade, MT
  • NPI 1902181563
  NPD (past)

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1841274248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SW 7TH ST STE A205",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572983",
            "telephone_number": "877-522-1275",
            "fax_number": "833-888-7145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3345 39TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047539",
            "telephone_number": "877-522-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNEQUIN",
        "first_name": "KARLA",
        "middle_name": "MAY",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7392724",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "A2437",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madeline Henke, RDN, LRD
• Samantha Jean Henkes
• Kori Angela Hennebry, MPH, PA-S
• Maria Hennen, OTR
• Paige Hennen
• Jill M Hennessy, PA-C
• Kayla Marie Hennum
• Stacy Henrich, CCC-SLP
• Alyssa Jean Henry
• Annah Nyamoita Henry

• Physician Assistant in Fargo, ND
• Providers in Fargo, ND by specialty
• Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.