Jennifer Kern Pennell, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

9701434 Issued in NC

Practice address

1020 Southhill Dr
Suite 380
Cary, NC 27513-8629

Phone

(919) 678-0008

Fax

(919) 678-0014

NPI assigned

Jul 23, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 5, 2016 through Jul 5, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Durham Finance Dept

  • Land Ambulance
  • Durham, NC
  • NPI 1437159613
  NPD (past)

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433203200000",
    "number": "1417979303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 SOUTHHILL DR",
            "address_2": "SUITE 380",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138629",
            "telephone_number": "919-678-0008",
            "fax_number": "919-678-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 SOUTHHILL DR",
            "address_2": "SUITE 380",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138629",
            "telephone_number": "919-678-0008",
            "fax_number": "919-678-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNELL",
        "first_name": "JENNIFER",
        "middle_name": "KERN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2015-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "9701434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Jones Pencille
• Ashley Pender, LCMHCA
• Julisa Lee Pendergraph
• Miranda Jane Pendergrass
• Naga Sri Anila Devi Penegalapati, BPT, MBA
• Elizabeth Ferguson Pennington, D.D.S.
• Antionque Colette Penny
• Penwell Counseling Services, PLLC
• Melissa Marie Penwell, MA, LCMHC, NCC
• Sara Pepka

• Psychiatry Physician in Cary, NC
• Providers in Cary, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.