JAYNE R PENNE (NPI# 1578825105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578825105 |
| Entity Type | Individual |
| Full Name | JAYNE R PENNE |
| Credential | PA-C |
| Practice Address |
825 Fairfax Ave Suite 445 Norfolk VA 23507-1914 |
| Mailing Address |
Po Box 936 Evms Medical Group Norfolk VA 23501-0936 |
| Practice Telephone | 7574468920 |
| Practice Fax Number | 7574465242 |
| Mailing Telephone | 7574468920 |
| Mailing Fax Number | 7574465242 |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2015-06-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
0110003827 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MULTIPLAN | PAR | 01 |
| VA | 1578825105 | 05 | |
| VA | CORVEL | PAR | 01 |
| VA | OPTIMA HEALTH | 10120878P | 01 |
| NC | 1578825105 | 05 | |
| VA | USA MANAGED CARE | PAR | 01 |
| Street Address |
825 FAIRFAX AVE SUITE 445 |
| City | NORFOLK |
| State | VA |
| Zip Code | 23507-1914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538167796 | Richard Norman Willard | Obstetrics & Gynecology | 825 Fairfax Ave, Suite 310, Norfolk, VA 23507-1914 | 2005-07-12 |
| 1053930800 | Seth Warren | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1914 | 2020-04-12 |
| 1235768730 | Chelsea Time Rubis | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1914 | 2020-04-06 |
| 1689203317 | Kristen Mcconnell Gogoli | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1912 | 2020-04-04 |
| 1003445040 | Mruna Jaymin Patel | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1914 | 2020-04-02 |
| 1750919130 | Mary Elizabeth Wade | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1912 | 2020-03-31 |
| 1982232773 | Bradley Nicolas Cotrina | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1914 | 2020-03-29 |
| 1841827821 | Miles Reese | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1914 | 2020-03-27 |
| 1053948083 | Colin Neils Chao | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1914 | 2020-03-27 |
| 1164984290 | Una Kosarac | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave, Norfolk, VA 23507-1914 | 2019-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790306801 | Paolo Quentin Rigo | Student in an Organized Health Care Education/Training Program | Smith Rogers Hall, 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-04-29 |
| 1811526221 | Sean M Whitty | Student in an Organized Health Care Education/Training Program | Emergency Medicine Residency, Raleigh Building, St 304, 600 Gresham Dr, Norfolk, VA 23507 | 2020-04-07 |
| 1962030643 | Shekinah Joy Vaughn | Student in an Organized Health Care Education/Training Program | 385 Mowbray Arch Ste 203205, Norfolk, VA 23507 | 2020-03-30 |
| 1982231403 | Jaxon Vallely | Student in an Organized Health Care Education/Training Program | 358 Mowbray Arch, Suite #203/205, Norfolk, VA 23507 | 2020-03-25 |
| 1437714656 | Kanishk Deep Sharma | Student in an Organized Health Care Education/Training Program | 825 Fairfax Avenue Eastern Virginia Medical School Inte, Suite 445, Norfolk, VA 23507 | 2019-05-02 |
| 1619439460 | Dylan Woolum | Student in an Organized Health Care Education/Training Program | Raleigh Building, Suite 304, 600 Gresham Drive, Norfolk, VA 23507 | 2019-04-02 |
| 1477012623 | Jessie R Jones | Student in an Organized Health Care Education/Training Program | 825 Fairfax Ave Ste 513a, Norfolk, VA 23507 | 2019-03-18 |
| 1316416787 | Lindsey Sawyer | Genetic Counselor, MS | Childrens Hospital of The Kings Daughters, 601 Childrens Lane, Norfolk, VA 23507 | 2018-11-15 |
| 1881188159 | Patrick Michael Haar | Pharmacist | 601 Pembroke Avenue, Apt 104, Norfolk, VA 23507 | 2018-06-19 |
| 1316438377 | Monika Pajhal | Student in an Organized Health Care Education/Training Program | Eastern Virginia Medical School (internal Medicine), Internal Medicine, 825 Fairfax Ave, Suite 410, Norfolk, VA 23507 | 2018-05-25 |
| Find all providers in zip 23507 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102347 | Mary Herrera | Physician Assistant | 6353 Center Dr Ste 204, Norfolk, VA 23502-0001 | 2020-04-05 |
| 1720614019 | Andrew James Meyers | Physician Assistant | 229 W Bute St Apt 207, Norfolk, VA 23510-1415 | 2020-03-18 |
| 1205345584 | Cassandra Lee Elverum | Physician Assistant | 600 Childrens Ln, Norfolk, VA 23507 | 2017-09-29 |
| 1790904456 | Thomas George Parish | Physician Assistant | 700 W Olney Rd, Norfolk, VA 23507-1607 | 2007-04-24 |
| 1649345372 | Ronald E Nave | Physician Assistant | 814 Kempsville Rd Ste 104, Norfolk, VA 23502-4001 | 2006-11-21 |
| 1073581823 | Karen Hintz Charlton | Physician Assistant | 1035 Nidar Blvd, Norfolk, VA 23521 | 2006-03-09 |
| 1902876931 | Mark Alan Gellasch | Physician Assistant | Branch Medical Clinic Norfolk, 1721 Taussig Blvd, Norfolk, VA 23511 | 2006-01-24 |
| 1073132551 | Ashley Makie | Physician Assistant | 3 Cedar St, Norfolk, MA 02056-1566 | 2020-04-14 |
| 1376179465 | Emily J Laughlin | Physician Assistant | 6379 Center Dr, Norfolk, VA 23502-4102 | 2020-03-20 |
| 1629604095 | Erin Anne Gray | Physician Assistant | 100 Kingsley Ln Ste 400, Norfolk, VA 23505-4604 | 2020-03-18 |
| Find all providers in NORFOLK | ||||
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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.