Active NPI
Taryn Pennington, ATC
- Athletic Trainer
- Pella, IA
National Provider Identifier
1013380104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 077474
- Practice address
- 812 University St
Central College Box 6600
Pella, IA 50219-1902 - Phone
- (641) 628-5453
- NPI assigned
- Nov 11, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 077474 | IA | MD | Athletic Trainer |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 077474 | IA | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
812 University St
Central College Box 6600
Pella, IA 50219-1902
Mailing address
812 University St
Central College Box 6600
Pella, IA 50219-1902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 11, 2015.
{
"created_epoch": "1447200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447200000000",
"number": "1013380104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "812 UNIVERSITY ST",
"address_2": "CENTRAL COLLEGE BOX 6600",
"city": "PELLA",
"state": "IA",
"postal_code": "502191902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 UNIVERSITY ST",
"address_2": "CENTRAL COLLEGE BOX 6600",
"city": "PELLA",
"state": "IA",
"postal_code": "502191902",
"telephone_number": "641-628-5453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNINGTON",
"first_name": "TARYN",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-11",
"last_updated": "2015-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IA",
"license": "077474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pella, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.