Individual provider Active NPI

Elyse Pennington, PHARMD

  • Pharmacist
  • Dry Ridge, KY
National Provider Identifier
1700243268
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
017739 Issued in KY
Practice address
4452 Sherman Mount Zion Rd
Dry Ridge, KY 41035-8429
Phone
(859) 393-3397
NPI assigned
Jan 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 017739 KY Primary

Addresses

Primary practice location

4452 Sherman Mount Zion Rd
Dry Ridge, KY 41035-8429

Mailing address

4452 Sherman Mount Zion Rd
Dry Ridge, KY 41035-8429
Phone (859) 393-3397

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
017739KYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1700243268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4452 SHERMAN MOUNT ZION RD",
            "city": "DRY RIDGE",
            "state": "KY",
            "postal_code": "410358429",
            "telephone_number": "859-393-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4452 SHERMAN MOUNT ZION RD",
            "city": "DRY RIDGE",
            "state": "KY",
            "postal_code": "410358429",
            "telephone_number": "859-393-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "ELYSE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "017739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dry Ridge, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.