Randal S Pennington, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

49478942501 Issued in UT

Practice address

750 North 200 West
Provo, UT 84601

Phone

(801) 373-4760

Fax

(801) 373-0639

NPI assigned

Aug 24, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sailor Health Medical PAGroup PAC ID 4486182342, 301 clinicians

Riverwoods Behavioral Health PCGroup PAC ID 4688194889, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Riverwoods Behavioral Health PC

  • Mental Health Counselor
  • Provo, UT
  • NPI 1417488040
  Medicare reassignment Care Compare group NPD
• Sailor Health Medical PA

  • Psychologist
  • Coral Gables, FL
  • NPI 1841012960

  UT

  Medicare reassignment Care Compare group
• Spinal Interventions, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Provo, UT
  • NPI 1053336917
  Medicare reassignment NPD
• Wasatch Behavioral Health Special Service District

  • Community/Behavioral Health Agency
  • Provo, UT
  • NPI 1356357115
  Medicare reassignment

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801903786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 NORTH 200 WEST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84601",
            "telephone_number": "801-373-4760",
            "fax_number": "801-373-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 NORTH 200 WEST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84601",
            "telephone_number": "801-373-4760",
            "fax_number": "801-373-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "RANDAL",
        "middle_name": "S",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "49478942501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katerina Corral Pena-Kennan
• Diego Pena IV
• Diego Pena, SSW
• Elisabeth Marie Pendleton
• Pennington Medical Center (Pennington Women's Center)
• Taylor Marie Percival
• Brittany Tucker Perdue, A.T.C.
• Carrie Pualanileimakamae Pereyra, ATC
• Karen Nazareth Perez Rodriguez
• Adam Perez

• Clinical Psychologist in Provo, UT
• Providers in Provo, UT by specialty
• Clinical Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.