JOHANNA HENDRICKSON (PA-C) – Physician Assistant, NPI 1447416516
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
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Provider Addresses for JOHANNA HENDRICKSON (PA-C)
PO BOX 27128
SALT LAKE CITY, UT 841270128
Phone: (435) 657-4400
Type: Mailing
Heber City, Heber, Wasatch County, Utah, 84032, United States
SUITE E
HEBER CITY, UT 840323522
Phone: (435) 657-4400
Type: Location
1840 Amherst St
Winchester, VA 226012808
Phone: (540) 536-8000
Fax: (540) 536-7780
Type: Location
400 Campus Blvd Ste 210
Winchester, VA 226016906
Phone: (540) 536-3470
Fax: (540) 536-3471
Type: Location
454 E MEDICAL WAY
HEBER CITY, UT 840321391
Phone: (435) 657-4400
Type: Location
220 CAMPUS BLVD STE 100
WINCHESTER, VA 226012896
Phone: (540) 536-5100
Fax: (540) 536-0235
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $19.
Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.
Last reported payment date: 2024-09-25 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($19).
Total Amount
$19
General + Research + Ownership
Payments
1
Total payment records
General Amount
$19
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $19 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-12-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20081104000316 | I | Physician Assistant | UT | TBD |
| I20210527000252 | I | Physician Assistant | VA | TBD |
| I20230327000348 | I | Physician Assistant | WV | TBD |
| I20241217004247 | I | Physician Assistant | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84127)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OR | |
| Diagnostic Radiology | UT | |
| Family Practice | UT | |
| H O S P I T A L I S T | UT | |
| O B S T E T R I C S/ G Y N E C O L O G Y | UT | |
| - | UT | |
| - | UT | |
| - | UT | |
| Family Practice | UT | |
| - | UT |
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