Active NPI
Jamie Penny
- Radiation Therapy Radiologic Technologist
- Wpafb, OH
National Provider Identifier
1063835593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Therapy Radiologic Technologist
- License
- T8861753
- Practice address
- 4881 Sugar Maple Dr
88TH Mdos/Sgomr
Wpafb, OH 45433-5529 - Phone
- (937) 257-4159
- NPI assigned
- Feb 4, 2014
- Last updated
- Feb 4, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Therapy Radiologic Technologist | 2471R0002X | T8861753 | OH | Primary |
Addresses
Primary practice location
4881 Sugar Maple Dr
88TH Mdos/Sgomr
Wpafb, OH 45433-5529
Mailing address
4881 Sugar Maple Dr
88TH Mdos/Sgomr
Wpafb, OH 45433-5529
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 |
|---|---|---|---|
| T8861753 | OH | MD | Radiation Therapy Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391472000000",
"number": "1063835593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4881 SUGAR MAPLE DR",
"address_2": "88TH MDOS/SGOMR",
"city": "WPAFB",
"state": "OH",
"postal_code": "454335529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4881 SUGAR MAPLE DR",
"address_2": "88TH MDOS/SGOMR",
"city": "WPAFB",
"state": "OH",
"postal_code": "454335529",
"telephone_number": "937-257-4159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNY",
"first_name": "JAMIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-04",
"last_updated": "2014-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "2471R0002X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Radiation Therapy",
"state": "OH",
"license": "T8861753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wpafb, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.