DR. STEPHANIE JO PENCHUK (NPI# 1063570224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063570224 |
| Entity Type | Individual |
| Full Name | DR. STEPHANIE JO PENCHUK |
| Credential | PHYSICIAN |
| Practice Address |
41 Sanderson Rd Ste 202 Smithfield RI 02917-2603 |
| Mailing Address |
41 Sanderson Rd Ste 202 Smithfield RI 02917 |
| Practice Telephone | 4012313138 |
| Practice Fax Number | 4012314757 |
| Mailing Telephone | 4012313138 |
| Mailing Fax Number | 4012314757 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2014-01-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | MD08739 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | STATE LICENCE | 73004 | 01 |
| RI | STATE LICENSE | MD08739 | 01 |
| DEA NUMBER | BP2346078 | 01 | |
| RI | SP40427 | 05 |
| Street Address |
41 SANDERSON RD STE 202 |
| City | SMITHFIELD |
| State | RI |
| Zip Code | 02917-2603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124473897 | Karen K. Mckenzie | Social Worker | 25 Thurber Blvd. Unit #2, Smithfield, RI 02917 | 2016-04-29 |
| 1518208818 | Phalanx Med Rhode Island, LLC | Durable Medical Equipment & Medical Supplies | 400 Putnam Pike, Suite J #232, Smithfield, RI 02917 | 2013-03-12 |
| 1710230453 | Lifeline Ambulance LLC | Ambulance | 130 Rocky Hill Road, Smithfield, RI 02917 | 2012-10-18 |
| 1689965337 | Cynthia Ann Tracy | Social Worker | 28 Cedar Swamp Road, Smithfield, RI 02917 | 2011-04-29 |
| 1871794636 | Denise Coffey | Counselor | 47a Cedar Swamp Rd, Smithfield, RI 02917 | 2007-05-30 |
| 1073637807 | National Mentor Healthcare, LLC | Day Training, Developmentally Disabled Services | 25 Thurber Blvd, Smithfield, RI 02917 | 2007-03-19 |
| 1124127998 | Senior Lifestyle North Bay Limited Partnership | Assisted Living Facility | 171 Pleasant View Ave, Smithfield, RI 02917 | 2006-09-21 |
| 1700899986 | Mary Kay Uchmanowicz | Audiologist | 151 Douglas Pike, Smithfield, RI 02917 | 2006-08-15 |
| 1689685042 | John Michael Corsi | Internal Medicine | 28 Cedar Swamp Rd, Smithfield, RI 02917 | 2006-08-11 |
| 1962442376 | Sharon Q Capuano | Nurse Practitioner | 1150 Douglas Pike, Smithfield, RI 02917 | 2006-06-07 |
| Find all providers in zip 02917 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699162438 | William Lowell | Pediatrics | 18055 Morgarts Beach Rd, Smithfield, VA 23430-2621 | 2015-04-20 |
| 1093096141 | Sunshine Pediatrics, Pa | Pediatrics | 1519 Booker Dairy Rd, Smithfield, NC 27577-9472 | 2011-09-02 |
| 1093809782 | Kimberly D Fox | Pediatrics | 1519 E Booker Dairy Rd, Smithfield, NC 27577-9472 | 2006-10-03 |
| 1831159391 | Sally Lawson Carpenter | Pediatrics | 11 Berkshire Rd, Smithfield, NC 27577-4748 | 2006-03-27 |
| 1609066273 | Johnston County Pediatrics | Pediatrics | 11 Berkshire Rd, Smithfield, NC 27577 | 2007-07-30 |
| 1528121191 | Trella Cooper | Pediatrics | 517 N Brightleaf Blvd, Smithfield, NC 27577-4407 | 2006-12-18 |
| 1255499752 | Johnston County Pediatrics | Pediatrics | 11 Berkshire Rd, Smithfield, NC 27577-4748 | 2006-12-05 |
| 1073547030 | Dinusha W Dietrich | Pediatrics | 41 Sanderson Rd, Ste 202, Smithfield, RI 02917-2603 | 2006-07-10 |
| 1346298973 | Lisa M.l. Parker | Pediatrics | 101 Kellie Dr, Smithfield, NC 27577-9443 | 2006-05-05 |
| 1629036256 | Debra J Tetreault | Pediatrics | 101 Kellie Dr, Smithfield, NC 27577-9443 | 2006-05-03 |
| Find all providers in SMITHFIELD | ||||
| City | SMITHFIELD |
| Zip Code | 02917 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.