Penney Retirement Community

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

LL598 Issued in FL

Legal business name

PENNEY RETIREMENT COMMUNITY

Practice address

2 Pavilion Place
Penney Farms, FL 32079

Phone

(904) 284-8579

NPI assigned

Dec 8, 2008

Last updated

Dec 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Paul Whitney Jewett, MD

Title

Physician Volunteer

Phone

(904) 284-4078

Specialties & licenses 1

Addresses

Tax ID family

Penney Retirement Community3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Outpatient Clinic at Penney Retirement Community, Inc.

  • Family Medicine Physician
  • Penney Farms, FL
  • NPI 1578919080
  NPD tax ID
• Penney Retirement Community, Inc.

  • Skilled Nursing Facility
  • Penney Farms, FL
  • NPI 1285991265
  NPD tax ID

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228694400000",
    "number": "1700021599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 HOFFMAN AVENUE",
            "city": "PENNEY FARMS",
            "state": "FL",
            "postal_code": "32079",
            "telephone_number": "904-284-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PAVILION PLACE",
            "city": "PENNEY FARMS",
            "state": "FL",
            "postal_code": "32079",
            "telephone_number": "904-284-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNEY RETIREMENT COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-08",
        "last_updated": "2008-12-08",
        "status": "A",
        "authorized_official_last_name": "JEWETT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "WHITNEY",
        "authorized_official_title_or_position": "PHYSICIAN VOLUNTEER",
        "authorized_official_telephone_number": "904-284-4078",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "FL",
            "license": "LL598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Issa.Med P.a.
• Kristina Ketterer, COTA
• Janet Keys, PTA
• Katarina Elaine Norton
• Outpatient Clinic at Penney Retirement Community, Inc.
• Penney Retirement Community, Inc.
• Tonyo Lorenzo Sylvester
• Laura E Watkins, PTA

• Nursing Facility/Intermediate Care Facility in Penney Farms, FL
• Providers in Penney Farms, FL by specialty
• Nursing Facility/Intermediate Care Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2008; 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.