Active NPI
David Austin Penglase, BACHELORS
- Adult Companion
- Kent, OH
National Provider Identifier
1770845158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- License
- S28610696
- Practice address
- 690 Morris Road Apartment 1
Kent, OH 44240 - Phone
- (978) 317-2851
- NPI assigned
- Jun 12, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion | 372600000X | S28610696 | MA | Primary |
Addresses
Primary practice location
690 Morris Road Apartment 1
Kent, OH 44240
Mailing address
690 Morris Rd Apt 1
Kent, OH 44240-3920
Phone (978) 317-2851
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S28610696 | MA | MD | Adult Companion |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339459200000",
"number": "1770845158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "690 MORRIS RD APT 1",
"city": "KENT",
"state": "OH",
"postal_code": "442403920",
"telephone_number": "978-317-2851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "690 MORRIS ROAD APARTMENT 1",
"city": "KENT",
"state": "OH",
"postal_code": "44240",
"telephone_number": "978-317-2851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENGLASE",
"first_name": "DAVID",
"middle_name": "AUSTIN",
"credential": "BACHELORS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-12",
"last_updated": "2012-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "MA",
"license": "S28610696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kent, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.