Wayne Allen Penniman, D.P.T., A.T.C, CSCS

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

11012 Issued in MA

Practice address

45 High St
Clinton, MA 01510-2906

Phone

(508) 826-5968

NPI assigned

Aug 1, 2007

Last updated

Jan 22, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Greendale Physical Therapy, LLC

  • Physical Therapist
  • Shrewsbury, MA
  • NPI 1053316182

  Orthopedic

  NPD (past)

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1700076064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 COLONIAL DR",
            "city": "CLINTON",
            "state": "MA",
            "postal_code": "015101469",
            "telephone_number": "508-826-5968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 HIGH ST",
            "city": "CLINTON",
            "state": "MA",
            "postal_code": "015102906",
            "telephone_number": "508-826-5968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNIMAN",
        "first_name": "WAYNE",
        "middle_name": "ALLEN",
        "credential": "D.P.T., A.T.C, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MA",
            "license": "11012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter D Oldak, M.D.
• Joshua A. Orabone, M.D., M.P.H.
• Danielle Pakus, B.S., CPD, CLE, CPT
• Jaymy Paredes
• Tejendra Patel, DMD
• Kellie Allison Peterson, BCBA
• Thanh Pham, D.M.D.
• Polus Center for Social & Economic Development
• Brittany Lynn Priest
• Neelima Ravi, DMD

• Orthopedic Physical Therapist in Clinton, MA
• Providers in Clinton, MA by specialty
• Orthopedic Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; 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.