Jeffrey Joseph Pennock, PTA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QB00043300 Issued in NJ

Practice address

798 Route 539 Ste 2
Little Egg Harbor TWP, NJ 08087-4203

Phone

(609) 294-4720

NPI assigned

Feb 24, 2006

Last updated

Mar 21, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206057600000",
    "number": "1710953302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1500",
            "city": "TUCKERTON",
            "state": "NJ",
            "postal_code": "080875500",
            "telephone_number": "609-294-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "798 ROUTE 539 STE 2",
            "city": "LITTLE EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "080874203",
            "telephone_number": "609-294-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNOCK",
        "first_name": "JEFFREY",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2008-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QB00043300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Little Egg Harbor TWP, NJ
• Providers in Little Egg Harbor TWP, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.