Active NPI
Gregory E Pennington, LCSW
- Clinical Social Worker
- Greenville, IL
National Provider Identifier
1073642294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149007651
- Practice address
- 200 Health Care Drive
Wellness Link Greenville Regional Hospital
Greenville, IL 62246 - Phone
- (618) 664-2922
- Fax
- (618) 664-0318
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149007651 | IL | Primary |
Addresses
Primary practice location
200 Health Care Drive
Wellness Link Greenville Regional Hospital
Greenville, IL 62246
Mailing address
200 Healthcare Drive
Suite 214 Gregory E Pennington Co Wellness Link
Greenville, IL 62246
Phone (618) 664-2922
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149007651 | Other | IL | MEDICAL LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149007651 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296777600000",
"number": "1073642294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HEALTHCARE DRIVE",
"address_2": "SUITE 214 GREGORY E PENNINGTON CO WELLNESS LINK",
"city": "GREENVILLE",
"state": "IL",
"postal_code": "62246",
"telephone_number": "618-664-2922",
"fax_number": "618-664-0318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 HEALTH CARE DRIVE",
"address_2": "WELLNESS LINK GREENVILLE REGIONAL HOSPITAL",
"city": "GREENVILLE",
"state": "IL",
"postal_code": "62246",
"telephone_number": "618-664-2922",
"fax_number": "618-664-0318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNINGTON",
"first_name": "GREGORY",
"middle_name": "E",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2011-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149007651",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "149007651",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.