Individual provider Active NPI

Weems R Pennington III, MD

  • Cardiovascular Disease Physician
  • Aiken, SC
National Provider Identifier
1215027263
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
22253 Issued in SC
Practice address
137 Miracle Dr
Aiken, SC 29801-6351
Phone
(803) 641-4874
Fax
(803) 641-0436
NPI assigned
Oct 13, 2006
Last updated
Mar 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 59309 GA
Cardiovascular Disease Physician 207RC0000X 22253 SC Primary

Addresses

Primary practice location

137 Miracle Dr
Aiken, SC 29801-6351

Mailing address

367 S. Gulph Rd
Att: Ipm Credentialing
King of Prussia, PA 19406-3121
Phone (803) 641-4874

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110104001029 SC Practitioner - Interventional CardiologyPractitioner - AnesthesiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4789758467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Medical College of Georgia School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

137 Miracle Dr
Aiken, SC 29801-6351
Phone (803) 226-0589

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting28
Pacemaker insertion or repair18
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
59309GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aiken Professional Association LLC Cardiovascular Disease CurrentSince Oct 13, 2014 Accepting new patients
Aiken Professional Association, LLC Cardiovascular Disease CurrentSince Oct 13, 2014 Accepting new patients
Bimal R Shah MD PC PastSince Mar 9, 2020 Accepting new patients

Locations

367 S Gulph Rd
Kng of Prussa, PA 19406
Phone (610) 382-4422

137 Miracle Dr
Aiken, SC 29801
Phone (803) 226-0589

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

440 Society Hill Dr
Ste 202
Aiken, SC 29803
Phone (803) 226-0102

336 Georgia Ave
Ste 102
North Augusta, SC 29841
Phone (803) 442-3006

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552003200000",
    "number": "1215027263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S. GULPH RD",
            "address_2": "ATT: IPM CREDENTIALING",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "803-641-4874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 MIRACLE DR",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016351",
            "telephone_number": "803-641-4874",
            "fax_number": "803-641-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "WEEMS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2019-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "59309",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "22253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.