JENNIFER ANNE PENNINGTON (NPI# 1114145687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114145687 |
| Entity Type | Individual |
| Full Name | JENNIFER ANNE PENNINGTON |
| Other Name | JENNIFER ANNE ANDREASCO |
| Credential | D.O. |
| Practice Address |
4630 Vistula Rd Mishawaka IN 46544-4000 |
| Mailing Address |
710 N Niles Ave South Bend IN 46617-1924 |
| Practice Telephone | 5746471900 |
| Practice Fax Number | 5742547222 |
| Mailing Telephone | 5746471610 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2016-03-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 02003207A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | RR MEDICARE | P00734479 | 01 |
| IN | BCBS MED POINT | 000000530214 | 01 |
| IN | BCBS BMG E BLAIR WARNER | 000000758919 | 01 |
| IN | 200874950 | 05 | |
| IN | BCBS BMG SCHWARTZ-WIEKAMP | 000000533533 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902306731 | Jennifer Pennington | Licensed Vocational Nurse | 14 Cr 4334, Bivins, TX 75555 | 2018-02-19 |
| 1326464413 | Jennifer Pennington | Occupational Therapy Assistant | 1000 Association Dr, Charleston, WV 25311-1270 | 2014-03-13 |
| 1114205770 | Jennifer L Pennington | Physical Therapist | 3 Windswept Dr, Nashville, IL 62263 | 2011-08-01 |
| 1093044711 | Jennifer Ann Pennington | Physical Therapist | 2204 S El Camino Real, Suite 102, Oceanside, CA 92054-6306 | 2009-12-08 |
| 1063748705 | Jennifer Martin Pennington | Counselor | 331 S Washington St, Shelby, NC 28150-5450 | 2009-10-31 |
| 1306936216 | Jennifer Lynn Pennington | Speech-Language Pathologist | 10020 Mahler Pl, Oklahoma City, OK 73120-3312 | 2006-10-13 |
| 1356386205 | Jennifer Anne Pennington | Occupational Therapist | 8001 T W Alexander Dr, Raleigh, NC 27617-4883 | 2006-06-17 |
| Street Address |
4630 VISTULA RD |
| City | MISHAWAKA |
| State | IN |
| Zip Code | 46544-4000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598763203 | Joseph Michael Caruso | Family Medicine | 4630 Vistula Rd, Mishawaka, IN 46544-4000 | 2005-07-07 |
| 1730523846 | Ryan Bonek | Family Medicine | 4630 Vistula Rd, Mishawaka, IN 46544-4000 | 2013-04-18 |
| 1508177619 | Daniel Walter Abel | Family Medicine | 4630 Vistula Rd, Mishawaka, IN 46544-4000 | 2010-06-24 |
| 1194941708 | Natalie Joy Frentz | Family Medicine | 4630 Vistula Rd, Mishawaka, IN 46544-4000 | 2007-04-18 |
| 1033161617 | Beacon Medical Group, Inc. | Family Medicine | 4630 Vistula Rd, Mishawaka, IN 46544-4000 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692676 | Lynnette Markowicz | Occupational Therapist | 1540 S. Logan St, Mishawaka, IN 46544 | 2020-09-08 |
| 1902429822 | Hellenic Senior Living of Mishawaka LLC | Assisted Living Facility | 1540 S. Logan Street, Mishawaka, IN 46544 | 2020-05-27 |
| 1184275422 | Lorrajean A Gleva | Technician | 203 Eastgate Circle, Mishawaka, IN 46544 | 2019-09-27 |
| 1376072785 | Aims, LLC | Psychologist | 1113 Mossy Lane, Mishawaka, IN 46544 | 2017-06-08 |
| 1760835912 | Ophelia Ansari | Nurse Practitioner | 4501 Linconway East, Mishawaka, IN 46544 | 2016-07-22 |
| 1598153355 | Hearing Aid Service | Hearing Instrument Specialist | 3718 Lincolnway E, Mishawaka, IN 46544 | 2015-01-02 |
| 1437587953 | Christopher Ryan Hazel | Dentist | 544 Lincolnway West, Mishawaka, IN 46544 | 2013-10-18 |
| 1699015941 | Frank Walerko | Urology | 809 Bittersweet Cove Drive, Mishawaka, IN 46544 | 2013-02-25 |
| 1023251337 | Josephine Schimizzi | Family Medicine | 1505 South Spring Street, Mishawaka, IN 46544 | 2009-04-16 |
| 1881831147 | Walgreen Co | Pharmacy | 4620 Lincolnway E, Mishawaka, IN 46544 | 2009-01-08 |
| Find all providers in zip 46544 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891222808 | Tess Lacie Edvardsen | Family Medicine | 611 East Douglas Rd, Ste 407, Family Medicine Center of Sjrmc, Mishawaka, IN 46545-1468 | 2017-05-22 |
| 1780070755 | Joseph John Bartush | Family Medicine | 1540 Trinity Pl, Mishawaka, IN 46545-5006 | 2015-04-07 |
| 1285048835 | Bethany Perrin | Family Medicine | 611 E. Douglas Rd, Ste 407, Mishawaka, IN 46545-1468 | 2014-06-11 |
| 1114347457 | Lynn Day | Family Medicine | 5209 Breezewood Dr, Mishawaka, IN 46544-4161 | 2014-04-25 |
| 1710325386 | Brigitte R Selio | Family Medicine | 611 E Douglas Rd Ste 407, Mishawaka, IN 46545-1468 | 2013-06-05 |
| 1689938664 | Christopher Jordan | Family Medicine | 611 E Douglas Rd Ste 137, Mishawaka, IN 46545-1464 | 2012-06-25 |
| 1417265349 | Patel Familymedicine | Family Medicine | 1625 Jefferson Ave, Mishawaka, IN 46545 | 2010-09-14 |
| 1023251337 | Josephine Schimizzi | Family Medicine | 1505 South Spring Street, Mishawaka, IN 46544 | 2009-04-16 |
| 1972776938 | Mishawaka Clinic, P.C. | Family Medicine | 303 S. Main St., Suite 212, Mishawaka, IN 46544 | 2008-04-10 |
| 1275755100 | Muhammad S. Arain | Family Medicine | St.joseph Va Clinic, 1540 Trinity Place, Mishawaka, IN 46545 | 2007-05-02 |
| Find all providers in MISHAWAKA | ||||
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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.