Lori Mandy Pennington, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001488 Issued in VA

Practice address

6315 North Center Dr
BLDG 20 Suite 230
Norfolk, VA 23502-3931

Phone

(757) 461-7974

Fax

(757) 461-4829

NPI assigned

Oct 11, 2005

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1295723526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6315 NORTH CENTER DR",
            "address_2": "BLDG 20 SUITE 230",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023931",
            "telephone_number": "757-461-7974",
            "fax_number": "757-461-4829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6315 NORTH CENTER DR",
            "address_2": "BLDG 20 SUITE 230",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023931",
            "telephone_number": "757-461-7974",
            "fax_number": "757-461-4829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "LORI",
        "middle_name": "MANDY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010198453",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shaney Marie Penberthy, NP
• Mia Pendergrass
• Latarsha Penn
• Melinda Marie Christie Penn, M.D.
• Jayne R Penne, PA-C
• Roy Mason Pennington III, MD
• Paige Elaina Penson
• Grace Mamarian Pentecost, D.D.S.
• People Helping All People
• Peoples Pharmacy LTC

• Optometrist in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Optometrist in Virginia

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.