Nicholas J Pennings, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1469 Issued in SC

Practice address

3816 Highway 17 S
North Myrtle Beach, SC 29582-5069

Phone

(843) 272-1411

NPI assigned

Jun 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Specialty

Family Practice

Education

Philadelphia College of Osteopathic Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Campbell University Health Center LLCGroup PAC ID 1254586308, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DGICBA
• Direct secure messaging: nicholas.pennings.1@22709.direct.athenahealth.com

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.

• Campbell University Health Center, LLC

  • Family Medicine Physician
  • Buies Creek, NC
  • NPI 1508117185
  Medicare reassignment Care Compare group NPD
• JS-Bell Enterprises, LLC

  • Plastic Surgery Physician
  • North Myrtle Beach, SC
  • NPI 1588993646

  Family Medicine

  NPD (past)
• Horizon Medical Group, P.C.

  • Family Medicine Physician
  • Goshen, NY
  • NPI 1063488179
  NPD (past)
• Horizon Medical Group, P.C.

  • Durable Medical Equipment & Medical Supplies
  • Yorktown Heights, NY
  • NPI 1386520021
  NPD (past)

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1982642096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3816 HIGHWAY 17 S",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295825069",
            "telephone_number": "843-272-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3816 HIGHWAY 17 S",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295825069",
            "telephone_number": "843-272-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGS",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "174478",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "1469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Patten
• Mohit Pawar, BS PHARMACY
• Sandra Lee Payne, APRN
• Peaceful Waves Counseling LLC
• Michelle Peele
• Robert Perry, RPH
• Kia Persaud, MBBS
• John A Pienkos, CH
• Tomorrow Pittman
• Forrest A Pommerenke, M.D.

• Family Medicine Physician in North Myrtle Beach, SC
• Providers in North Myrtle Beach, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; 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.
• 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.