Active NPI
Jennifer Nicole Pennington Taylor, PA-C
- Medical Physician Assistant
- Hinton, WV
National Provider Identifier
1487644290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 01014
- Practice address
- 1500 Terrace Street
Hinton, WV 25951 - Phone
- (304) 466-2905
- Fax
- (304) 466-2917
- NPI assigned
- Oct 24, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 01014 | WV | Primary |
Addresses
Primary practice location
1500 Terrace Street
Hinton, WV 25951
Mailing address
1500 Terrace Street
PO Box 940
Hinton, WV 25951
Phone (304) 466-2905
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810001365 | Medicaid | WV | |
| 520795528 | Other | WV | AETNA |
Other names 1
- Miss Jennifer Nicole Pennington
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01014 | WV | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Appalachian Regional Healthcare, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Rural Health Clinic/Center
- Hinton, WV
- NPI 1730196049
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487644290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 TERRACE STREET",
"address_2": "PO BOX 940",
"city": "HINTON",
"state": "WV",
"postal_code": "25951",
"telephone_number": "304-466-2905",
"fax_number": "304-466-2917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 TERRACE STREET",
"city": "HINTON",
"state": "WV",
"postal_code": "25951",
"telephone_number": "304-466-2905",
"fax_number": "304-466-2917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNINGTON TAYLOR",
"first_name": "JENNIFER",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WV",
"license": "01014",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810001365",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "520795528",
"state": "WV"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "PENNINGTON",
"middle_name": "NICOLE",
"prefix": "MISS",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Hinton, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.