Individual provider Active NPI

James William Pennington, M.D.

  • Family Medicine Physician
  • Hood River, OR
National Provider Identifier
1942284955
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD17665 Issued in OR
Practice address
1021 June St
Hood River, OR 97031-1516
Phone
(541) 386-2204
Fax
(541) 386-6566
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD17665 OR Primary

Addresses

Primary practice location

1021 June St
Hood River, OR 97031-1516

Mailing address

1021 June St
Hood River, OR 97031-1516
Phone (541) 386-2204

Other identifiers 1

IdentifierTypeStateIssuer
042015MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20090102000467 OR Practitioner - Family Practice 6305908146 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17665ORMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Oct 25, 2009 Accepting new patients
Providence Health & Services Oregon Family Medicine CurrentSince Oct 25, 2009 Accepting new patients
Summit Family Medicine - LLC Family Medicine CurrentSince Feb 1, 2009 Accepting new patients

Locations

810 12th St
Hood River, OR 97031
Phone (541) 386-3911

1021 June St
Ste 101104
Hood River, OR 97031

1021 June St
Ste 101
Hood River, OR 97031

1021 June St
Hood River, OR 97031
Phone (541) 386-0007

Interoperability endpoints

  • Direct secure messaging: james.pennington@326763223121924.direct.elationemr.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1942284955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 JUNE ST",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311516",
            "telephone_number": "541-386-2204",
            "fax_number": "541-386-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 JUNE ST",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311516",
            "telephone_number": "541-386-2204",
            "fax_number": "541-386-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "JAMES",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD17665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042015",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hood River, OR

Sources for this page

Verify at the official NPI Registry.