Active NPI
John Penington Jr., MD
- Emergency Medicine Physician
- Daytona Beach, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- ME30791
- Practice address
- 303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709 - Phone
- (386) 254-2285
- Fax
- (386) 425-1304
- NPI assigned
- Nov 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME0030791 | FL | |
| Emergency Medicine Physician | 207P00000X | ME30791 | FL | Primary |
Addresses
Primary practice location
303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Mailing address
303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Phone (386) 254-2285
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ME30791 | Other | FL | STATE MEDICAL LICENSE |
| 066074400 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME30791 | FL | MD | Emergency Medicine Physician |
| ME0030791 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Halifax Healthcare Systems Inc | Emergency Medicine | Current | Accepting new patients |
| Halifax Healthcare Systems Inc | Past | Accepting new patients |
Locations
303 N Clyde Morris Blvd
Fl 10
Daytona Beach, FL 32114
Phone (386) 425-2360
303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285
Use Ci1660
Orlando, FL 32886
740 Dunlawton Ave
Ste 100
Port Orange, FL 32127
Phone (386) 767-2402
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Daytona Beach, FL
- NPI 1245283530
Emergency Medicine
-
- Cardiovascular Disease Physician
- Daytona Beach, FL
- NPI 1366452591
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456531200000",
"number": "1598839136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 N CLYDE MORRIS BLVD",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321142709",
"telephone_number": "386-254-2285",
"fax_number": "386-425-1304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 N CLYDE MORRIS BLVD",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321142709",
"telephone_number": "386-254-2285",
"fax_number": "386-425-1304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENINGTON",
"first_name": "JOHN",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-17",
"last_updated": "2016-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME0030791",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "ME30791",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE MEDICAL LICENSE",
"identifier": "ME30791",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "066074400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2016; 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.