NPIMap

Individual provider Active NPI

Tracey O Pennington, M.D.,M.P.H.

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Virginia Beach, VA
National Provider Identifier
1497791669
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
0101231849 Issued in VA
Practice address
5320 Providence Rd
Suite 204
Virginia Beach, VA 23464-4122
Phone
(757) 962-2121
Fax
(757) 962-1911
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 0101231849 VA Primary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 0101231849 VA

Addresses

Primary practice location

5320 Providence Rd
Suite 204
Virginia Beach, VA 23464-4122

Mailing address

5320 Providence Rd
Suite 204
Virginia Beach, VA 23464-4122
Phone (757) 962-2121

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061002000309 VA Practitioner - Physical Medicine and Rehabilitation 0648220210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Tulane University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

733 Volvo Pkwy
Suite 200
Chesapeake, VA 23320-1609
Phone (757) 962-2121

Hospital & facility affiliations

  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Sentara Albemarle Medical Center Hospital, Elizabeth City, NC, CCN 340109
  • Chesapeake General Hospital Hospital, Chesapeake, VA, CCN 490120

Merit-based Incentive Payment System (MIPS)

Final score
72.26 of 100Reported as individual
Quality
25.02
Improvement activities
40
Cost
93.82

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101231849VAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Management & Orthopedic Center PC CurrentSince Feb 20, 2011 Accepting new patients

Locations

733 Volvo Pkwy
Ste 200
Chesapeake, VA 23320
Phone (757) 547-5851

5320 Providence Rd
Ste 204
Virginia Beach, VA 23464
Phone (757) 523-9755

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71895

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1497791669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5320 PROVIDENCE RD",
            "address_2": "SUITE 204",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644122",
            "telephone_number": "757-962-2121",
            "fax_number": "757-962-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 PROVIDENCE RD",
            "address_2": "SUITE 204",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644122",
            "telephone_number": "757-962-2121",
            "fax_number": "757-962-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "TRACEY",
        "middle_name": "O",
        "name_prefix": "Ms.",
        "credential": "M.D.,M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "VA",
            "license": "0101231849",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "VA",
            "license": "0101231849",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.