Alexis Ambrose Pennington, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202006328 Issued in VA

Practice address

5604 Virginia Beach Blvd Ste 101
Virginia Beach, VA 23462-5631

Phone

(757) 455-5000

NPI assigned

Sep 21, 2023

Last updated

Sep 21, 2023By the provider in NPPES

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

Other names 1

• Alexis Ambrose Rudd Former name

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Legacy Healthcare Services Inc

  • Physical Therapist
  • Roanoke, VA
  • NPI 1740820828

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• JP Therapy, LLC

  • Physical Rehabilitation Occupational Therapist
  • Virginia Beach, VA
  • NPI 1851770598
  NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1871371716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 50TH ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235082019",
            "telephone_number": "757-895-5465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 VIRGINIA BEACH BLVD STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625631",
            "telephone_number": "757-455-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "ALEXIS",
        "middle_name": "AMBROSE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-21",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202006328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "RUDD",
            "middle_name": "AMBROSE",
            "credential": "M.S., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peninsula Institute for Community Health Inc (Virginia Beach Housing Resource Center Health Clinic)
• Peninsula Institute for Community Health Inc (Virginia Beach Family Medicine)
• Bojana Penjevic, DPT
• Cassidy Elizabeth Penley, COTA
• Pennington Group Full Spectrum Services
• Tracey O Pennington, M.D.,M.P.H.
• Peoples Behavioral Health
• Peoples Transport Service LLC
• Melissa Peppenhorst
• Janice Pepper

• Speech-Language Pathologist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.