Danelle L Pennock, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

478 Issued in SD

Practice address

904 W 23Rd St
Ste 101 Heartland Psychological Services
Yankton, SD 57078

Phone

(605) 665-0841

Fax

(605) 665-0096

NPI assigned

Aug 6, 2009

Last updated

Sep 23, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Danelle L Koch Former name

Medicare fee-for-service enrollment

Enrolled in SD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heartland Psychological ServicesGroup PAC ID 3476535725, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Heartland Psychological Services

  • Psychiatry Physician
  • Yankton, SD
  • NPI 1679574578

  Clinical

  Medicare reassignment Care Compare group NPD
• Heartland Psychological Services

  • Mental Health Counselor
  • Yankton, SD
  • NPI 1568708683
  NPD (past)

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1740411859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 W 23RD ST",
            "address_2": "STE 101 HEARTLAND PSYCHOLOGICAL SERVICES",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "57078",
            "telephone_number": "605-665-0841",
            "fax_number": "605-665-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 W 23RD ST",
            "address_2": "STE 101 HEARTLAND PSYCHOLOGICAL SERVICES",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "57078",
            "telephone_number": "605-665-0841",
            "fax_number": "605-665-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNOCK",
        "first_name": "DANELLE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-06",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SD",
            "license": "478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6552900",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANELLE",
            "last_name": "KOCH",
            "middle_name": "L",
            "prefix": "MS.",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristen Pederson
• Linda Peitz
• Rachelle Peitz
• Robert Peitz, MA, LPC
• Abigail Peltier, MSW, LCSW, QHMP
• Sara Pepper, MD
• Judith R Peterson, MD
• Linda K Peterson, CRNA
• Michael E Peterson, M.D.
• Savannah M Pewett

• Clinical Psychologist in Yankton, SD
• Providers in Yankton, SD by specialty
• Clinical Psychologist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.