Marygrace Pennella, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

08001966A Issued in IN

Practice address

9780 Lantern Rd
Suite 230
Fishers, IN 46037-4092

Phone

(317) 863-0365

NPI assigned

Mar 28, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2000

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Stillpoint Family Chiropractic, Inc

  • Chiropractor
  • Fishers, IN
  • NPI 1245429711
  Medicare reassignment NPD

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265551899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9780 LANTERN RD",
            "address_2": "SUITE 230",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460374092",
            "telephone_number": "317-863-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9780 LANTERN RD",
            "address_2": "SUITE 230",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460374092",
            "telephone_number": "317-863-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNELLA",
        "first_name": "MARYGRACE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001966A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200316610A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatric Products, LLC (Express Nebs)
• Jeremiah Xavier Peeler
• Julie Marie Pelzel, M.A., CCC-SLP
• Pence Family Dentistry, LLC
• Orey O Pence, DDS
• Zoe Pentecost
• Hanna Penwell
• Ladoris Peppers
• Isabella Perez
• Reagan Perry

• Chiropractor in Fishers, IN
• Providers in Fishers, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.