Jeffrey Aaron Pennock I, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT9358 Issued in FL

Practice address

15071 Shell Point Blvd
Fort Myers, FL 33908-1639

Phone

(239) 454-2256

Fax

(239) 466-1240

NPI assigned

Aug 29, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthpro Heritage Rehab and Fitness LLCGroup PAC ID 6507832573, 976 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Coral Gables, FL
  • NPI 1871972653

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Empowerme Rehabilitation Florida, LLC

  • Multi-Specialty Clinic/Center
  • Stuart, FL
  • NPI 1184257602
  Medicare reassignment NPD
• Empowerme Rehabilitation Florida, LLC

  • Rehabilitation Clinic/Center
  • The Villages, FL
  • NPI 1477245892
  NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462

  Occupational Therapist

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1093297715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15071 SHELL POINT BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339081639",
            "telephone_number": "239-454-2256",
            "fax_number": "239-466-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15071 SHELL POINT BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339081639",
            "telephone_number": "239-454-2256",
            "fax_number": "239-466-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNOCK",
        "first_name": "JEFFREY",
        "middle_name": "AARON",
        "name_suffix": "I",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-29",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT9358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edgar Comson Penano, P.T.
• Carlo T Penaranda, P.T.
• Dexter Penaranda
• Alexander M Pendino, D.O.
• Sharica Pennington
• Kevin Matthew Pennycook, DO
• Zachary William Penrod, DO
• Heloisa Pentian, ARNP - FNP-C
• James W Penuel Jr., MD
• Emily Sue Pepe

• Occupational Therapist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.