Aliecia Diann Penrod

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2016037455 Issued in MO

Practice address

1420 Woodland Dr
Jackson, MO 63755-1510

Phone

(573) 587-4204

NPI assigned

Aug 14, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1821771015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 WOODLAND DR",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637551510",
            "telephone_number": "573-587-4204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 WOODLAND DR",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637551510",
            "telephone_number": "573-587-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENROD",
        "first_name": "ALIECIA",
        "middle_name": "DIANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2016037455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pappas Chiropractic Health Center, P.C.
• Philip Christ Pappas, DC
• Jake Ryan Partridge, M.S. SLP-CCC
• Patriot Medical Supplies
• Patriot Medical Supplies
• Charles S Pewitt, DO
• Julia Annette Pewitt, D.O.
• Richel Pingkian
• Lindsey Michelle Pippins, MABC, BT, QIDP, DDP
• Kaitlyn C Poythress, MA, BCBA, LBA

• Physical Therapy Assistant in Jackson, MO
• Providers in Jackson, MO by specialty
• Physical Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.