Active NPI
Jacob Todd Pennington II
- Case Manager/Care Coordinator
- Poteau, OK
National Provider Identifier
1306202643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 900 N Broadway St
Suite 1
Poteau, OK 74953-2617 - Phone
- (918) 649-0772
- NPI assigned
- Dec 31, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
900 N Broadway St
Suite 1
Poteau, OK 74953-2617
Mailing address
PO Box 1335
Poteau, OK 74953-1335
Phone (918) 649-0772
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451520000000",
"number": "1306202643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1335",
"city": "POTEAU",
"state": "OK",
"postal_code": "749531335",
"telephone_number": "918-649-0772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 N BROADWAY ST",
"address_2": "SUITE 1",
"city": "POTEAU",
"state": "OK",
"postal_code": "749532617",
"telephone_number": "918-649-0772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNINGTON",
"first_name": "JACOB",
"middle_name": "TODD",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-12-31",
"last_updated": "2015-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poteau, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.