Individual provider Active NPI

Tammy M. Pennington, MD

  • Psychiatry Physician
  • Louisville, KY
National Provider Identifier
1417095746
Registry record updated Oct 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
42503 Issued in KY
Practice address
501 E Broadway Ste 340
Louisville, KY 40202-1799
Phone
(502) 852-5395
NPI assigned
Feb 1, 2007
Last updated
Oct 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X R1255 KY
Psychiatry Physician 2084P0800X 42503 KY Primary

Addresses

Primary practice location

501 E Broadway Ste 340
Louisville, KY 40202-1799

Mailing address

4201 Springhurst Blvd
Ste 203
Louisville, KY 40241
Phone (502) 425-6690

Other names 1

  • Mrs. Tammy M. Pennington Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160401001868 PA Practitioner - Psychiatry 1951453513 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Louisville School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Services Group IncGroup PAC ID 1052201571, 32 clinicians

Practice addresses (Care Compare)

1000 Commerce Park Dr
Suite 110
Williamsport, PA 17701-5475
Phone (570) 323-6944

4133 Medical Ctr Dr
Broad Top, PA 16621

4133 Medical Ctr Dr
Broad Top, PA 16621-9001
Phone (814) 635-2916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R1255KYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Broad Top Area Medical Center Inc Current Accepting new patients
Community Services Group, Inc. CurrentSince Feb 22, 2016 Accepting new patients
Broad Top Area Medical Center Inc CurrentSince Feb 25, 2022 Accepting new patients
Broad Top Area Medical Center Inc CurrentSince Feb 25, 2022 Accepting new patients

Locations

375 S Kishacoquillas St
Belleville, PA 17004
Phone (717) 935-2065

4133 Medical Center Dr
Broad Top, PA 16621
Phone (814) 506-8463

358 Seminary St
Cassville, PA 16623
Phone (814) 448-9226

6674 Towne Center Blvd
Huntingdon, PA 16652
Phone (814) 643-1232

6678 Towne Center Blvd
Huntingdon, PA 16652
Phone (814) 506-8490

790 Bryan St
Huntingdon, PA 16652
Phone (814) 643-8300

790 Bryan St
#2
Huntingdon, PA 16652
Phone (814) 506-8114

814 Washington St
Huntingdon, PA 16652
Phone (814) 623-4415

95 S Park St
Mount Union, PA 17066
Phone (814) 542-8627

320 Highland Dr
Mountville, PA 17554
Phone (717) 285-7121

626 Water St
Ste 1
Orbisonia, PA 17243
Phone (814) 447-5556

1000 Commerce Park Dr
Ste 110
Williamsport, PA 17701
Phone (570) 323-6944

Interoperability endpoints

  • Direct secure messaging: t.pennington@broadtopmedical.medentdirect.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792281600000",
    "number": "1417095746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 SPRINGHURST BLVD",
            "address_2": "STE 203",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40241",
            "telephone_number": "502-425-6690",
            "fax_number": "502-425-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E BROADWAY STE 340",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021799",
            "telephone_number": "502-852-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "TAMMY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2026-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "R1255",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "42503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMMY",
            "last_name": "PENNINGTON",
            "middle_name": "M.",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.