MARK W HENNICKE (NPI# 1487611307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487611307 |
| Entity Type | Individual |
| Full Name | MARK W HENNICKE |
| Credential | PA-C |
| Practice Address |
530 South St Second Floor Greensburg PA 15601-2775 |
| Mailing Address |
520 Jefferson Ave Suite 400 Jeannette PA 15644-2538 |
| Practice Telephone | 7246891358 |
| Practice Fax Number | 7246890547 |
| Mailing Telephone | 7245278060 |
| Mailing Fax Number | 7245224002 |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2016-11-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA002773L | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
530 SOUTH ST SECOND FLOOR |
| City | GREENSBURG |
| State | PA |
| Zip Code | 15601-2775 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548267198 | Mark A. Zelkovic | Surgery | 530 South St, Suite 300, Greensburg, PA 15601-2775 | 2005-06-28 |
| 1578193991 | Excela Health Physician Practices, Inc | Surgery | 530 South St, Greensburg, PA 15601-2775 | 2020-01-24 |
| 1669880993 | Jerod Craig Smith | Nurse Practitioner | 530 South St, Suite 380, Greensburg, PA 15601-2775 | 2014-07-30 |
| 1598185506 | Robert Alexander Pearce | Internal Medicine | 530 South St, Greensburg, PA 15601-2775 | 2014-04-17 |
| 1285053835 | Kaleigh Adkins | Specialist/Technologist | 530 South St, Greensburg, PA 15601-2775 | 2014-04-10 |
| 1134562879 | Ashwin Krishnan Thiagarajasubramanian | Internal Medicine | 530 South St, Greensburg, PA 15601-2775 | 2013-04-11 |
| 1710288311 | Andrea N Altieri | Physician Assistant | 530 South St, Suite 300, Greensburg, PA 15601-2775 | 2010-11-12 |
| 1356662688 | Daniel Lee Meikle | Surgery | 530 South St, Suite G10, Greensburg, PA 15601-2775 | 2010-06-22 |
| 1386880227 | Rishi Kad | Internal Medicine | 530 South St, Second Floor, Greensburg, PA 15601-2775 | 2008-12-24 |
| 1093965329 | Elizabeth L. Detschelt | Radiology | 530 South St, Suite 380, Greensburg, PA 15601-2775 | 2008-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689274128 | Chelsea Anne Lyle | Counselor | Yaroch Counseling, 437 S Maple Ave, Greensburg, PA 15601 | 2020-10-26 |
| 1538649280 | Valor Healthcare Inc | Nurse Practitioner | 5274 Route 30 East, Suite 10, Greensburg, PA 15601 | 2018-08-21 |
| 1285121889 | Eugene Flenner Jr. | Orthotist | 3 Gibraltar Way, Greensburg, PA 15601 | 2018-04-18 |
| 1417461724 | Westmoreland County Area Agency On Aging | Case Management | 200 South Main St., Greensburg, PA 15601 | 2017-11-22 |
| 1225549769 | Beth Ann Marie Schmidle | Nurse Practitioner | 540 South Street - Medical Commons 2, Suite 302, Greensburg, PA 15601 | 2017-10-23 |
| 1386167138 | Connections Counseling of Western Pa | Community/Behavioral Health | 231 S Main Street, Suite 404, Greensburg, PA 15601 | 2017-07-24 |
| 1164963112 | Cory Kunicky | Counselor | 333 Harvey Avenue, Greensburgh, PA 15601 | 2017-03-10 |
| 1801348826 | Flow Spine & Sport LLC | Chiropractor | 123 Donohoe Drive, Greensburg, PA 15601 | 2016-10-25 |
| 1235583402 | Marc James Aukerman | Chiropractor | 424 Frye Farm Road, Greensburg, PA 15601 | 2016-04-14 |
| 1336502806 | Claire Campero | Counselor | One Northgate Square Ste 200, Greensburg, PA 15601 | 2016-04-01 |
| Find all providers in zip 15601 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487277703 | Riann Paige Tyree | Physician Assistant | 724 W Lincoln Ave, Greensburg, KS 67054-2522 | 2020-05-20 |
| 1699220962 | Abigail Diehl | Physician Assistant | 5274 Rte 30 Ste 10, Greensburg, PA 15601-7831 | 2016-08-16 |
| 1558772178 | Debra A Yothers Lucas | Physician Assistant | 1952 Brinkerton Rd, Greensburg, PA 15601-8226 | 2014-05-16 |
| 1134544505 | Toni Fontana | Physician Assistant | 504 Fulton St, Greensburg, PA 15601-4402 | 2014-02-21 |
| 1750613345 | Karla D Gorio | Physician Assistant | 490 Sitman St, Greensburg, LA 70441-1207 | 2010-02-05 |
| 1447581053 | Heather Lynn Lawrence | Physician Assistant | 545 Rugh St Ste 5000, Greensburg, PA 15601 | 2010-01-21 |
| 1104978204 | Linda Susan Desantis | Physician Assistant | 325 Alexander Ave, Greensburg, PA 15601-2827 | 2007-01-17 |
| 1780653436 | Nancy L Kisner | Physician Assistant | 502 Walnut St, Greensburg, KS 67054 | 2006-03-15 |
| 1073593141 | Marie Pirillo | Physician Assistant | 912 S Main St, Greensburg, PA 15601-4141 | 2006-01-17 |
| 1780682559 | Mark Desantis | Physician Assistant | 118 Nature Park Rd Ste 300, Greensburg, PA 15601-6960 | 2005-07-14 |
| Find all providers in GREENSBURG | ||||
| City | GREENSBURG |
| Zip Code | 15601 |
Please comment or provide details below to improve the information on MARK W HENNICKE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.