Weems R Pennington III, MD
Individual provider Active NPI Cardiovascular Disease Physician · Aiken, SC
NPI 1215027263 · NPPES record last updated Mar 8, 2019
Key facts
- NPI
- 1215027263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 22253 (SC)
- Practice address
- 137 Miracle Dr
Aiken, SC 29801-6351 - Phone
- (803) 641-4874
- Fax
- (803) 641-0436
- NPI assigned
- Oct 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 3
Medicare Care Compare profile
- 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
- Aiken Professional Association LLC
Practice addresses (Care Compare)
137 Miracle Dr
Aiken, SC 29801-6351
Phone (803) 226-0589
Hospital & facility affiliations
- Aiken Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 28 |
| Pacemaker insertion or repair | 18 |
| Varicose vein removal | 1-10 |
| Leg revascularization (restoring blood flow) | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110104001029 | SC | Practitioner - Interventional Cardiology |
4789758467 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59309 | GA | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aiken Professional Association, LLC | Cardiovascular Disease | Current |
Accepting new patients |
| Aiken Professional Association LLC | Cardiovascular Disease | Current |
Accepting new patients |
| Bimal R Shah MD PC | Past |
Accepting new patients |
Locations
367 S Gulph Rd
Kng of Prussa, PA 19406
Phone (610) 382-4422
440 Society Hill Dr
Ste 202
Aiken, SC 29803
Phone (803) 226-0102
137 Miracle Dr
Aiken, SC 29801
Phone (803) 226-0589
302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940
336 Georgia Ave
Ste 102
North Augusta, SC 29841
Phone (803) 442-3006
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 59309 | GA | |
| Cardiovascular Disease Physician | 207RC0000X | 22253 | SC | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G59309 | Medicaid | SC |
Other providers in Aiken, SC
- Peak Rehabilitation, Fitness and Performance Center LLC
- Pediatric Therapy of Aiken, LLC
- Pediatric Therapy of Aiken, LLC
- Susan B Pelc
- Pelvic Prime, LLC
- Taylor Greene Pennisi
- Pepper Hill SNF Operations LLC
- Shannon W Pepper
- Hamna Talha Peracha
- Performanceabove LLC
All providers in Aiken, SC · Cardiovascular Disease Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.