Active NPI
Amanda Pennington, MD
- Pediatrics Physician
- Elkins, WV
National Provider Identifier
1649433202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 24442
- Practice address
- 812 Gorman Ave
Elkins, WV 26241-3181 - Phone
- (304) 637-3894
- Fax
- (304) 637-0435
- NPI assigned
- Jul 3, 2008
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 24442 | WV | Primary |
Addresses
Primary practice location
812 Gorman Ave
Elkins, WV 26241-3181
Mailing address
812 Gorman Ave
Elkins, WV 26241-3181
Phone (304) 637-3894
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810020336 | Medicaid | WV |
Other names 1
- Amanda Butcher
Medicare participation
Medicare enrollment files- 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: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Davis Memorial Hospital | Current | Accepting new patients | |
| Davis Memorial Hospital | Current | Accepting new patients |
Locations
812 Gorman Ave
Elkins, WV 26241
Phone (304) 636-3300
Interoperability endpoints
- amanda.pennington.p1@direct.davismedicalcenter.nextgenshare.com
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.
-
- General Acute Care Hospital
- Elkins, WV
- NPI 1619964806
-
- Community/Retail Pharmacy
- Elkins, WV
- NPI 1700663226
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446508800000",
"number": "1649433202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "812 GORMAN AVE",
"city": "ELKINS",
"state": "WV",
"postal_code": "262413181",
"telephone_number": "304-637-3894",
"fax_number": "304-637-0435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 GORMAN AVE",
"city": "ELKINS",
"state": "WV",
"postal_code": "262413181",
"telephone_number": "304-637-3894",
"fax_number": "304-637-0435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNINGTON",
"first_name": "AMANDA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-03",
"last_updated": "2015-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WV",
"license": "24442",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810020336",
"state": "WV"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "BUTCHER",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Elkins, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.