Pennington Facial Plastics, LLC

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

205826 Issued in LA

Legal business name

PENNINGTON FACIAL PLASTICS, LLC

Practice address

345 Drexel Dr
Shreveport, LA 71106-2305

Phone

(505) 715-3338

NPI assigned

May 24, 2017

Organization subpart

No

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

Authorized official

Name

Lindsey Pennington, MD

Title

Sole MBR

Phone

(505) 715-3338

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Skylar Amanda Souyoul, M.D.

  • Dermatology Physician
  • Shreveport, LA
  • NPI 1407198690
  NPD (past)

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495584000000",
    "number": "1619405404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 DREXEL DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711062305",
            "telephone_number": "505-514-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 DREXEL DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711062305",
            "telephone_number": "505-715-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNINGTON FACIAL PLASTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-24",
        "last_updated": "2017-05-24",
        "status": "A",
        "authorized_official_last_name": "PENNINGTON",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "505-715-3338",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "LA",
            "license": "205826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2144464",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen M'Liss Pendleton, M.D.
• Rodney La'Ree Pendleton, D.D.S.
• Glenis Joyce Penn
• Lisa Harrison Penn, CAC
• Robert L Penn, M.D.
• Lindsey Alexander Pennington, MD
• Mariana Penny
• Ashton Pennywell
• Brianna Nicole Pennywell
• Danielle Pennywell

• Facial Plastic Surgery Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Facial Plastic Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.