Jerry L. Pennington, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2641 Issued in WV

Practice address

497 Mall Rd
Oak Hill, WV 25901-6216

Phone

(304) 574-2076

Fax

(304) 574-1068

NPI assigned

Aug 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jerry.pennington.1@16450.direct.athenahealth.com

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.

• New River Health Association, Inc.

  • Federally Qualified Health Center (FQHC)
  • Oak Hill, WV
  • NPI 1386318756
  Medicare reassignment NPD
• New River Health Association, Inc.

  • Federally Qualified Health Center (FQHC)
  • Oak Hill, WV
  • NPI 1457846362
  Medicare reassignment NPD
• New River Health Association, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fayetteville, WV
  • NPI 1003301912
  NPD
• New River Health Association, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lookout, WV
  • NPI 1346426103
  NPD
• New River Health Association, Inc.

  • Federally Qualified Health Center (FQHC)
  • Smithers, WV
  • NPI 1689220402
  NPD
• New River Health Association, Inc.

  • Federally Qualified Health Center (FQHC)
  • Scarbro, WV
  • NPI 1811983331
  NPD

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1568655413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 MALL RD",
            "city": "OAK HILL",
            "state": "WV",
            "postal_code": "259016216",
            "telephone_number": "304-469-2905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "497 MALL RD",
            "city": "OAK HILL",
            "state": "WV",
            "postal_code": "259016216",
            "telephone_number": "304-574-2076",
            "fax_number": "304-574-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "JERRY",
        "middle_name": "L.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "2641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810009746",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander Parsons
• Bonnie S Passal
• Dean Caleb Paxton, D.D.S.
• Teresa Pearson
• Jeannette Pennington
• Sara Pennington
• Amy Perdue
• Kimberly D Perkins
• Petersen Clinic, PLLC
• Bruce Norman Petersen, DO

• Dentist in Oak Hill, WV
• Providers in Oak Hill, WV by specialty
• Dentist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.