Clayton William Pennington, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

DR.0060612 Issued in CO

Practice address

1120 15TH St
Augusta, GA 30912-0004

Phone

(706) 721-2423

Fax

(706) 721-6918

NPI assigned

Jun 23, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Ophthalmology

Education

Medical College of Georgia School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trauma and Emergency Subspecialty Surgeons PLLCGroup PAC ID 1951559293, 27 clinicians

Wellensiek Eye Care, LLCGroup PAC ID 8224208061, 2 clinicians

Colorado Eye Surgeons LLCGroup PAC ID 5799194379, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Colorado Eye Surgeons, LLC

  • Ophthalmology Physician
  • Denver, CO
  • NPI 1376126284
  Medicare reassignment Care Compare group NPD Authorized official
• Trauma and Emergency Subspecialty Surgeons PLLC

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Highlands Ranch, CO
  • NPI 1740543933
  Medicare reassignment Care Compare group NPD
• Wellensiek Eye Care, LLC

  • Optometrist
  • Lakewood, CO
  • NPI 1699077446
  Medicare reassignment Care Compare group NPD
• Cherry Creek Eye Physicians &

  • Specialist
  • Denver, CO
  • NPI 1114950250
  Medicare reassignment NPD
• Colorado Eye Surgeons, P.C.

  • Ophthalmology Physician
  • Denver, CO
  • NPI 1578599114
  NPD (past)
• Elite Anesthesia Concepts Inc

  • Anesthesiology Physician
  • Castle Rock, CO
  • NPI 1215049804
  NPD (past)

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1467867002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-2423",
            "fax_number": "706-721-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "CLAYTON",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "6905",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "DR.0060612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000167500",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "029071",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pendley Personal Care Home Inc.
• James Walker Penland Jr., COTA/L
• Penn Heart LLC
• Penn Teck Diagnostics Inc
• Jaime Penn
• Weems R Pennington Jr., MD
• Joseph Frank Pensabene, MD
• Cassandre Neotha Marseille Perard
• John Paul Percival, FNP-C
• Paul Perdue, RPH

• Ophthalmology Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Ophthalmology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.