Individual provider Active NPI

Robert Frank Pennino, D.C.

  • Chiropractor
  • Boca Raton, FL
National Provider Identifier
1194838003
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7611 Issued in FL
Practice address
1943 N Federal Hwy
Boca Raton, FL 33432-1934
Phone
(561) 391-8446
Fax
(561) 391-8443
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7611 FL Primary

Addresses

Primary practice location

1943 N Federal Hwy
Boca Raton, FL 33432-1934

Mailing address

1943 N Federal Hwy
Boca Raton, FL 33432-1934
Phone (561) 391-8446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050917000006 FL Practitioner - Chiropractic 6800829250 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew M Cohen PA Chiropractor PastSince Jun 15, 2005 Accepting new patients
Southeast Medical Centers Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1194838003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1943 N FEDERAL HWY",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334321934",
            "telephone_number": "561-391-8446",
            "fax_number": "561-391-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1943 N FEDERAL HWY",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334321934",
            "telephone_number": "561-391-8446",
            "fax_number": "561-391-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINO",
        "first_name": "ROBERT",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.