Individual provider Active NPI

Penny Ann Wood, B.A.

  • Case Manager/Care Coordinator
  • Maynardville, TN
National Provider Identifier
1730511510
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
4330 Maynardville Hwy
Maynardville, TN 37807-3618
Phone
(865) 992-3849
Fax
(865) 992-5166
NPI assigned
Aug 5, 2013
Last updated
Aug 5, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NU Primary

Addresses

Primary practice location

4330 Maynardville Hwy
Maynardville, TN 37807-3618

Mailing address

6350 W Andrew Johnson Hwy
Department 100
Talbott, TN 37877-8605
Phone (800) 355-3565

Other names 1

  • Penny Ann Holt Former name

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
Bachelor of Arts

NPI Registry JSON

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

{
    "created_epoch": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375660800000",
    "number": "1730511510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6350 W ANDREW JOHNSON HWY",
            "address_2": "DEPARTMENT 100",
            "city": "TALBOTT",
            "state": "TN",
            "postal_code": "378778605",
            "telephone_number": "800-355-3565",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 MAYNARDVILLE HWY",
            "city": "MAYNARDVILLE",
            "state": "TN",
            "postal_code": "378073618",
            "telephone_number": "865-992-3849",
            "fax_number": "865-992-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "PENNY",
        "middle_name": "ANN",
        "credential": "B.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-05",
        "last_updated": "2013-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENNY",
            "last_name": "HOLT",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maynardville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; 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.