Timothy Mark Pennington, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

020820 Issued in OH

Practice address

4222 Grand Ave
Middletown, OH 45044-6129

Phone

(513) 420-4678

Fax

(513) 420-4678

NPI assigned

May 16, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1494892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494892800000",
    "number": "1952838310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PARKVIEW ST",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450362242",
            "telephone_number": "15133795697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4222 GRAND AVE",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450446129",
            "telephone_number": "513-420-4678",
            "fax_number": "513-420-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "TIMOTHY",
        "middle_name": "MARK",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-16",
        "last_updated": "2017-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "020820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia A. Peebles, LSW
• Katherine Mackenzie Pelfrey, MS, RDN, LD
• Regina Pendleton
• Wayne G Pendleton Jr.
• Evynn Pennington
• Tina Marie Pennington, LPN
• Traci Susanne Pennock, D.C.
• Percy D Mitchell Jr M D & Associates LLC
• Sharon K Perry, LSW
• Teresa Perry

• Family Nurse Practitioner in Middletown, OH
• Providers in Middletown, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2017; 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.