Amy R Henderson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085006656 Issued in IL

Practice address

9951 Rock Cut Xing
Loves Park, IL 61111-1999

Phone

(815) 639-8500

Fax

(815) 639-8501

NPI assigned

Jul 24, 2018

Sex

Female

Sole proprietor

No

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527

  IL

  Medicare reassignment Care Compare group NPD
• Saint Anthony Medical Center

  • Hematology & Oncology Physician
  • Rockford, IL
  • NPI 1942248802

  IL

  Medicare reassignment Care Compare group
• Saint Anthony Medical Center

  • Rural Health Clinic/Center
  • Loves Park, IL
  • NPI 1558067975
  Care Compare group NPD
• Saint Anthony Medical Center

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1790739977
  Care Compare group NPD (past)
• Saint Anthony Medical Center

  • Home Health Agency
  • Loves Park, IL
  • NPI 1023051992
  Care Compare group
• Saint Anthony Medical Center

  • Family Medicine Physician
  • Loves Park, IL
  • NPI 1508567298
  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

• Saint Anthony Medical Center

  • Home Health Agency
  • Loves Park, IL
  • NPI 1023051992
  Care Compare affiliation
• Saint Anthony Medical Center

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1790739977

  Hospital

  Care Compare affiliation
• Swedishamerican Hospital

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1760542732

  Hospital

  Care Compare affiliation

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Saint Anthony Medical Center

  • Rural Health Clinic/Center
  • Loves Park, IL
  • NPI 1558067975

  Contracted Managing Employee, Operational/Managerial Control

  CMS ownership

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Osf Multi-Specialty Group 2,123 clinicians

Saint Anthony Medical Center 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Healthcare Home Care Home health agency, Loves Park, IL, CCN 147271
• Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233
• Uw Health Hospital, Rockford, IL, CCN 140228

Medicare fee-for-service enrollment

Enrolled in IL

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

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 24, 2018.

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1861979700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9951 ROCK CUT XING",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611111999",
            "telephone_number": "815-639-8500",
            "fax_number": "815-639-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9951 ROCK CUT XING",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611111999",
            "telephone_number": "815-639-8500",
            "fax_number": "815-639-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "AMY",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085006656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Hatch, LCPC
• Sarah Elizabeth Hawkins, M.P.T.
• Healing Pathways, PLLC
• Dylan Heine, DPT
• Meghan Erin Hembrough
• Phil J. Herlihey, D.D.S.
• Joshua Hermanson
• Dakota Chance Thomas Heshelman, LCPC
• Highland Park CVS LLC
• Roger H Hill, OD

• All providers in Loves Park, IL
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.