PNCC Diagnostics LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

PNCC DIAGNOSTICS LLC

Practice address

1117 Columbia Rd NW
Washington, DC 20009-5964

Phone

(202) 387-0168

NPI assigned

Apr 29, 2024

Organization subpart

No

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

Authorized official

Name

Jessica Carpenter, MDNPI 1578695409

Title

Physician

Phone

(202) 387-0168

Specialties & licenses 1

Addresses

Other names 1

• PNCC Diagnostics LLC Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Lynn Carpenter, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Roanoke, VA
  • NPI 1578695409
  NPD Authorized official

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1114773363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 COLUMBIA RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200095964",
            "telephone_number": "202-387-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 COLUMBIA RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200095964",
            "telephone_number": "202-387-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PNCC DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "202-387-0168",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PNCC Diagnostics LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Point of Service in Washington, DC
• Providers in Washington, DC by specialty
• Point of Service in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.