Charles Penvose, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

36.003998 Issued in OH

Practice address

1920 Tamarack Rd
Newark, OH 43055-2303

Phone

(740) 344-8286

Fax

(740) 522-0094

NPI assigned

Feb 13, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 6

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marietta Memorial HospitalGroup PAC ID 8224928965, 387 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marietta Memorial Hospital Hospital, Marietta, OH, CCN 360147
• Selby General Hospital Hospital, Marietta, OH, CCN 361319

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Marietta Memorial Hospital

  • Rural Health Clinic/Center
  • Woodsfield, OH
  • NPI 1962106328
  Medicare reassignment Care Compare group NPD
• Foot and Ankle Specialists of Central Ohio, LLC

  • Podiatrist
  • Gahanna, OH
  • NPI 1629382247

  Foot & Ankle Surgery

  Medicare reassignment NPD
• Selby General Hospital

  • Critical Access Hospital
  • Marietta, OH
  • NPI 1124073465
  Medicare reassignment NPD
• Foot and Ankle Specialists of Central Ohio LLC

  • Durable Medical Equipment & Medical Supplies
  • Westerville, OH
  • NPI 1093685208
  NPD
• Marietta Memorial Hospital

  • General Acute Care Hospital
  • Marietta, OH
  • NPI 1215936927
  NPD
• Selby General Hospital

  • Rural Health Clinic/Center
  • Logan, OH
  • NPI 1710840251
  NPD

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

• Marietta Memorial Hospital

  • General Acute Care Hospital
  • Marietta, OH
  • NPI 1215936927
  Care Compare affiliation
• Selby General Hospital

  • Critical Access Hospital
  • Marietta, OH
  • NPI 1124073465
  Care Compare affiliation

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1144853649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552303",
            "telephone_number": "740-344-8286",
            "fax_number": "740-522-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552303",
            "telephone_number": "740-344-8286",
            "fax_number": "740-522-0094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2434 Richmiller Ln Unit C",
            "address_purpose": "LOCATION",
            "city": "Belpre",
            "state": "OH",
            "postal_code": "457141075",
            "country_code": "US",
            "telephone_number": "740-423-3207",
            "fax_number": "740-423-3227",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 University Estates Blvd Unit 100",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "OH",
            "postal_code": "457012967",
            "country_code": "US",
            "telephone_number": "740-566-4640",
            "fax_number": "740-566-4641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "206 Columbus RD STE 303",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "OH",
            "postal_code": "457011316",
            "country_code": "US",
            "telephone_number": "740-423-3103",
            "fax_number": "740-423-3117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENVOSE",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-13",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD001444",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36.003998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0444143",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charles.penvose@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "807 Farson St Ste 204C",
            "city": "Belpre",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457141069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charles.penvose@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "206 Columbus Rd Ste 202",
            "city": "Athens",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457011316",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpenvose24957@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "affiliationName": "Licking Memorial Professional Corporation",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charles.penvose@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "206 Columbus RD STE 303",
            "city": "Athens",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457011316",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charles.penvose@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "2434 Richmiller Ln Unit C",
            "city": "Belpre",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457141075",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charles.penvose@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "20 University Estates Blvd Unit 100",
            "city": "Athens",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457012967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stella Mae Pegan
• Paris Pelletier
• Hannah Elizabeth Pellett, CNP
• Katelyn Ann Pennington
• Amy Beth Penrose, LPN
• Nicholas Tyler Perichak, O.D, M.S.
• Sydney Perkins
• Katheryn Perse
• Peggy Sue Pesimer
• Emily Pessel

• Foot & Ankle Surgery Podiatrist in Newark, OH
• Providers in Newark, OH by specialty
• Foot & Ankle Surgery Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.
• 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.