NPIMap

Individual provider Active NPI

Angela M Pennell, M.D.

  • Anesthesiology Physician
  • Grand Junction, CO
National Provider Identifier
1124242177
Registry record updated Dec 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
47928 Issued in CO
Practice address
2635 N 7TH St
Grand Junction, CO 81501-8209
Phone
(970) 244-2273
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2006-00599 NC
Anesthesiology Physician 207L00000X 47928 CO Primary

Addresses

Primary practice location

2635 N 7TH St
Grand Junction, CO 81501-8209

Mailing address

1120 Wellington Ave
Suite 206
Grand Junction, CO 81501-6129
Phone (970) 243-7245

Other identifiers 1

IdentifierTypeStateIssuer
97604381MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090826000801 CO Practitioner - Anesthesiology 8224183215 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consultants of Western Colorado, PLLCGroup PAC ID 8921995754, 28 clinicians

Practice addresses (Care Compare)

2635 N 7TH St
Grand Junction, CO 81501-8209
Phone (970) 298-2273

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47928COMDAnesthesiology Physician
2006-00599NCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ketamine Infusion Specialists Anesthesiology Current Accepting new patients
Anesthesia Consultants of Western Colorado, PLLC Anesthesiology CurrentSince Aug 4, 2009 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Nov 1, 2020 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Nov 1, 2020 Accepting new patients
Intermountain Medical Group Grand Junction, LLC Current Accepting new patients

Locations

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

1120 Wellington Ave
Ste 206
Grand Junction, CO 81501
Phone (970) 243-7245

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mid Michigan Home Health and Hospice LLCFlint, MI, CCN 231640 Hospice Corporate Director (100%) Mar 10, 2011

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261526400000",
    "number": "1124242177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 WELLINGTON AVE",
            "address_2": "SUITE 206",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016129",
            "telephone_number": "970-243-7245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 N 7TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018209",
            "telephone_number": "970-244-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNELL",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2009-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2006-00599",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "47928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "97604381",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.