Connie Jo Pennington, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

30358 Issued in TN

Practice address

800 S Gay St Ste 100
Knoxville, TN 37929-4040

Phone

(423) 534-9029

NPI assigned

Jul 8, 2005

Reactivated

Mar 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

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

Colorectal Surgery (Proctology)

Education

Eastern Virginia Medical School, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Hospice, an Adventa Company Hospice, Elizabethton, TN, CCN 441534
• Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Blue Ridge Medical Management Corporaiton

  • Endocrinology, Diabetes & Metabolism Physician
  • Johnson City, TN
  • NPI 1245685858
  NPD
• Blue Ridge Medical Management Corporation

  • Urgent Care Clinic/Center
  • Elizabethton, TN
  • NPI 1144380833
  NPD
• Blue Ridge Medical Management Corporation

  • Family Medicine Physician
  • Johnson City, TN
  • NPI 1982553756
  NPD

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

• Adventa Hospice, LLC

  • Community Based Hospice Care Agency
  • Elizabethton, TN
  • NPI 1518925783
  Care Compare affiliation
• Mountain States Health Alliance

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1023434339
  Care Compare affiliation
• Mountain States Health Alliance

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1962915652
  Care Compare affiliation
• Mountain States Health Alliance

  • General Acute Care Hospital
  • Johnson City, TN
  • NPI 1972606465
  Care Compare affiliation

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1790783330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TALLAPOOSA RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376047187",
            "telephone_number": "423-534-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S GAY ST STE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379294040",
            "telephone_number": "423-534-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "CONNIE",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2006-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "30358",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD0000030358",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3875906",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3370584",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peninsula Outpatient Pharmacy - Knox
• Margie Nell Penn
• Marissa Leah Penn, LCSW
• Eric R Penniman, DO
• Amy Pennington-Springs, LPN
• Kathrynn Tyeler Pennington
• Sarah Ann Penny
• Nina Penson
• Alicia Nicole Penton
• Jordan Lindsay Pentz, CRNA

• Surgery Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.