Justin Ryan Penninger, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

RTL24-0279 Issued in NC

Practice address

6013 Farrington Rd
Chapel Hill, NC 27517-8172

Phone

(984) 974-6669

Fax

(984) 974-9609

NPI assigned

Apr 22, 2024

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 NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: jpenninger1157996@direct.unc.nchie.net
• Direct secure messaging: jpenninger550319@directhisp.wakemed.org

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1851146823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PEDIATRIC EDUCATION OFFICE CAMPUS BOX 7593",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275994220",
            "telephone_number": "919-966-3172",
            "fax_number": "984-974-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6013 FARRINGTON RD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275178172",
            "telephone_number": "984-974-6669",
            "fax_number": "984-974-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGER",
        "first_name": "JUSTIN",
        "middle_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "RTL24-0279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Z. Pendleton-White, SLP
• Avani Pendse, MD, PHD
• Lysandra Rose Penn-Bartoo, LCSW
• David L Penn, PHD
• Mary Catherine Penn
• Emily Penny, AGPCNP-BC
• Anne Morgan Penrose, M.ED, RDN, LDN
• Andrea Penton, PH.D.
• Amy Amanda Penwarden, MD
• Katherine Pepin, AGNP

• Student in an Organized Health Care Education/Training Program in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Student in an Organized Health Care Education/Training Program in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.