Pennic, Wooten& Associates Family Medical Care PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PENNIC, WOOTEN& ASSOCIATES FAMILY MEDICAL CARE PA

Practice address

1760 Edgewood Ave W
B
Jacksonville, FL 32208-7209

Phone

(904) 358-8480

Fax

(904) 358-8460

NPI assigned

Apr 17, 2006

Organization subpart

No

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

Authorized official

Name

Sonya Lucas

Title

Office Mananger

Phone

(904) 358-8480

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1194789958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 EDGEWOOD AVE W",
            "address_2": "B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322087209",
            "telephone_number": "904-358-8480",
            "fax_number": "904-358-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 EDGEWOOD AVE W",
            "address_2": "B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322087209",
            "telephone_number": "904-358-8480",
            "fax_number": "904-358-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNIC, WOOTEN& ASSOCIATES FAMILY MEDICAL CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-17",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "SONYA",
        "authorized_official_title_or_position": "OFFICE MANANGER",
        "authorized_official_telephone_number": "904-358-8480"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD #",
            "identifier": "34367",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Penemarie K Murphy Inc
• Penemarie K Murphy, Inc
• Penemarie K Murphy, Inc
• Alvin Penix Jr., LCSW, MSW, CBHCM
• Tanuja Tejesvi Penmatsa, M.D
• Willie A Pennick, MD
• Douglas Michael Pennington, D.O.
• Mary Beth Pennington, RD,LD/N
• Suzie Pennington
• Wednesday Pennington

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.