Active NPI
Patrick Pennypacker, PT, DPT
- Physical Therapist
- Collegeville, PA
National Provider Identifier
1396484556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT030440
- Practice address
- 1850 Collegeville Rd
Collegeville, PA 19426-3976 - Phone
- (610) 454-0780
- Fax
- (610) 489-2949
- NPI assigned
- Jun 3, 2022
- Last updated
- Jun 30, 2022
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT030440 | PA | Primary |
Addresses
Primary practice location
1850 Collegeville Rd
Collegeville, PA 19426-3976
Mailing address
1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224
Phone (914) 294-4050
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT030440 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656547200000",
"number": "1396484556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1311 MAMARONECK AVE STE 140",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106055224",
"telephone_number": "914-294-4050",
"fax_number": "631-760-8360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1850 COLLEGEVILLE RD",
"city": "COLLEGEVILLE",
"state": "PA",
"postal_code": "194263976",
"telephone_number": "610-454-0780",
"fax_number": "610-489-2949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNYPACKER",
"first_name": "PATRICK",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-03",
"last_updated": "2022-06-30",
"certification_date": "2022-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT030440",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Collegeville, PA
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- Perkiomen Valley School District
- Erin E Perveiler, MSS, LSW
- Carolyn Ann Phillips
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.