Jennifer W Pennoyer MD LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

JENNIFER W PENNOYER MD LLC

Practice address

701 Cottage Grove Road
E110
Bloomfield, CT 06002

Phone

(860) 243-3020

Fax

(860) 243-3002

NPI assigned

Apr 17, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer White Pennoyer, MDNPI 1982665725

Title

Member

Phone

(860) 243-3020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer W Pennoyer, M.D.

  • Dermatology Physician
  • Bloomfield, CT
  • NPI 1982665725
  Medicare reassignment Care Compare group NPD Authorized official
• Lynn Fairchild, PA

  • Physician Assistant
  • Bloomfield, CT
  • NPI 1366403107
  Medicare reassignment Care Compare group
• Caitlin Patricia Soucy

  • Medical Physician Assistant
  • Bloomfield, CT
  • NPI 1255990578
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841254653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 COTTAGE GROVE ROAD",
            "address_2": "E110",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "06002",
            "telephone_number": "860-243-3020",
            "fax_number": "860-243-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 COTTAGE GROVE ROAD",
            "address_2": "E110",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "06002",
            "telephone_number": "860-243-3020",
            "fax_number": "860-243-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER W PENNOYER MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PENNOYER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "WHITE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "860-243-3020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tejasvini Goud Jangam
• Janice Reeder Aprn LLC (Janice Reeder LLC)
• Jennifer Marie Jay, R.D.
• Jean M. Lafayette, LLC (Dr. Jean Lafayette & Dr. Tina Liang)
• Eliman K Jeng
• Jill R. Cristo Ma LMFT LLC
• Joel M. Miller M.D. PC
• Lisa M Johnson-Holloway, L.C.S.W.
• Keniesha Johnson, LCSW
• Samantha Johnson

• Dermatology Physician in Bloomfield, CT
• Providers in Bloomfield, CT by specialty
• Dermatology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.