David Ross Penn, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

072605 Issued in GA

Practice address

4045 Mt Zion Pkwy
Stockbridge, GA 30281

Phone

(770) 919-5238

Fax

(470) 781-5393

NPI assigned

Jun 26, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Interventional Radiology

Education

University of Florida College of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Atlanta Vascular Institute, LLCGroup PAC ID 7315289972, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southern Regional Medical Center Hospital, Riverdale, GA, CCN 110165
• Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18188/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/BIJACD

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

• South Atlanta Vascular Institute, LLC

  • Vascular Surgery Physician
  • Stockbridge, GA
  • NPI 1063903078

  Vascular & Interventional Radiology

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Piedmont Henry Hospital, Inc.

  • General Acute Care Hospital
  • Stockbridge, GA
  • NPI 1225034333
  Care Compare affiliation
• Prime Healthcare Foundation - Southern Regional, LLC

  dba Southern Regional Medical Center

  • General Acute Care Hospital
  • Riverdale, GA
  • NPI 1154795581
  Care Compare affiliation

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1760644355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 MT ZION PKWY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-919-5238",
            "fax_number": "470-781-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 MT ZION PKWY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-919-5238",
            "fax_number": "470-781-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "DAVID",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "GA",
            "license": "072605",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "30815",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Services of America, LLC (Aveanna Heatlhcare)
• Deanna Peisel, NNP
• Isamar Pena
• Penco Partners LLC
• Vincent T Peng, MD
• George Kevin Perdue, D.O.
• Neville G Pereyo, M.D.
• Javier Josae Perez Gonzalez, DMD
• Performance Physical Therapy, PC
• Brittney Perkins

• Vascular & Interventional Radiology Physician in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Vascular & Interventional Radiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.