Andre Michael Pennardt, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

35909 Issued in MT

Practice address

401 W Pennsylvania Ave
Anaconda, MT 59711-1931

Phone

(406) 563-8585

NPI assigned

Jan 17, 2006

Last updated

Sep 1, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Emergency Medicine Physicians of Craven County, PLLC

  • Emergency Medicine Physician
  • New Bern, NC
  • NPI 1164462586
  NPD (past)
• Emergency Medicine Physicians of Lenoir County PLLC

  • Emergency Medicine Physician
  • Kinston, NC
  • NPI 1518906478
  NPD (past)

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1174502280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W PENNSYLVANIA AVE",
            "city": "ANACONDA",
            "state": "MT",
            "postal_code": "597111931",
            "telephone_number": "406-563-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W PENNSYLVANIA AVE",
            "city": "ANACONDA",
            "state": "MT",
            "postal_code": "597111931",
            "telephone_number": "406-563-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNARDT",
        "first_name": "ANDRE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "9900962",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "036592",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME112439",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MT",
            "license": "35909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Grace Owen, MD
• Roger Pafford, M.D.
• Shelly Jane Parkman, LCAC, LPC
• Austin Peaslee, BCBA
• Tara Pelletier
• Performance Physical Therapy, PC (Premier Physical Therapy)
• Jonathan B Pine, DO
• Pintler Creek Counseling LLC
• Pintler Health & Rehab, LLC (Pintler Physical Therapy & Sports Rehab)
• Pintler Peaks Anesthesia, LLC

• Emergency Medicine Physician in Anaconda, MT
• Providers in Anaconda, MT by specialty
• Emergency Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.