Amanda Marie Pennington, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20333 Issued in SC

Practice address

1656 Riverchase Blvd
Rock Hill, SC 29732-1724

Phone

(803) 329-5131

Fax

(803) 366-6600

NPI assigned

Jul 16, 2006

Last updated

Jul 8, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2017 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Shiland Family Medicine

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1124357124
  NPD (past)

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1144247099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602120",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602120",
            "telephone_number": "803-329-5131",
            "fax_number": "803-366-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1656 RIVERCHASE BLVD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321724",
            "telephone_number": "803-329-5131",
            "fax_number": "803-366-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "20333",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9300562",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203336",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144247099",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "66763",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8966763",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080152242",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatric Eye Care & Strabismus, P.C.
• Pedo Carolina, Inc. (Rock Hill Pediatric Dentistry)
• Jennifer E Peelman, PA-C
• Alphonso Peeples, DDS
• Joy Pendarvis, CF-SLP
• Larry H Pennington, MD
• Morgan Whitesides Pennington, FNP-BC
• Perinatal Insights LLC
• Kimberly A. Perkins, CRNA
• Satianna Perry-Prysock, RBT

• Family Medicine Physician in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.