DR. ELLIOT CARR PENNINGTON


Address: 330 Barclay Ave Ne Ste 202, Grand Rapids, MI 49503-2525
Phone: 6164581722

DR. ELLIOT CARR PENNINGTON (NPI# 1235365081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1235365081
Entity Type Individual
Full Name DR. ELLIOT CARR PENNINGTON
Credential MD
Practice Address 330 Barclay Ave Ne Ste 202
Grand Rapids
MI 49503-2525
Practice Telephone 6164581722
Practice Fax Number 6164580061
Mailing Telephone 6164581722
Mailing Fax Number 6164580061
Enumeration Date 2009-06-08
Last Update Date 2020-08-13
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0120X Surgery
Specialization: Pediatric Surgery
1235365081 MI Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
330 Barclay Ave Ne Ste 202, Grand Rapids, MI 495032525 6164438007 6164580061

Office Location

Street Address 330 BARCLAY AVE NE STE 202
City GRAND RAPIDS
State MI
Zip Code 49503-2525

Providers in the same location

NPI Name Taxonomy Address Enumeration
1285115162 Jessica Nicole Andrina Registered Nurse 330 Barclay Ave Ne Ste 202, Grand Rapids, MI 49503-2525 2018-08-28

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1801496195 Airway Oxygen, Inc. Durable Medical Equipment & Medical Supplies Lemmen Holton Cancer Pavilion, 145 Michigan St Ne Ste 3400, Grand Rapids, MI 49503 2020-10-27
1730707282 Adriana Molina-schmuker Counselor 901 Eastern Avenue Ne, Grand Rapids, MI 49503 2020-07-10
1477176949 Kimberly Buskirk Specialist 1131 Ionia Ava Nw, Grand Rapids, MI 49503 2020-05-19
1124647805 Jared Host Speech-Language Pathologist Mercy Health Hauenstein Neuroscience Center 220 Cherry, Grand Rapids, MI 49503 2020-04-13
1265061378 Heather Gladfelter Student in an Organized Health Care Education/Training Program 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 2020-04-02
1194368647 Amy Jo Arends Nurse Practitioner 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 2019-10-28
1376185199 Beth Arce Occupational Therapist 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 2019-10-14
1295387256 Althea Ziolkowski Licensed Practical Nurse Salvation Army Turning Point Programs, 1215 Fulton St E, Grand Rapids, MI 49503 2019-07-10
1790340719 Heather Anne Fox Occupational Therapist Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 2019-05-06
1184182883 April L Kaiserlian Social Worker 983 Spaulding Ave Ne, Ada, MI 49503 2019-03-12
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Taxonomy Information

Taxonomy Code 2086S0120X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Pediatric Surgery

Taxonomy Definition

A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1205197639 Marcus P Haw Surgery 100 Michigan St Ne, 10th Floor, Mc 248, Grand Rapids, MI 49503-2560 2012-06-01
1114159415 Daniel Joseph Watkins Surgery 330 Barclay Ave Ne, Suite 202, Grand Rapids, MI 49503-2556 2009-08-20
1679622765 Robert Robert Connors Surgery 330 Barclay Ave Ne, Suite 202, Grand Rapids, MI 49503-2556 2007-01-09
1326197625 James Michael Decou Surgery 330 Barclay Ave Ne, Suite 202, Grand Rapids, MI 49503-2556 2007-01-09
1326197476 Neal Duane Uitvlugt Surgery 330 Barclay Ave Ne, Suite 202, Grand Rapids, MI 49503-2556 2007-01-09
1235288317 Marc Godfrey Schlatter Surgery 330 Barclay Ave Ne, Suite202, Grand Rapids, MI 49503-2556 2007-01-09
1578501573 Daniel John Robertson Surgery 330 Barclay Ave Ne, Suite 202, Grand Rapids, MI 49503-2556 2006-06-02

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1346444270 Pavan Brahmamdam Surgery 3535 W 13 Mile Rd # 307, Medical Office Building, Royal Oak, MI 48073-6770 2007-06-13
1700908423 Susan Hershberg Adelman Surgery 29820 Woodland Dr, Southfield, MI 48034-1339 2007-04-04
1891742128 Ajith K Kadakol Surgery 1701 South Blvd E Ste B75, Rochester Hills, MI 48307-6122 2006-05-30
1336147461 Joseph Lawrence Lelli Surgery Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 2005-07-12
1912322009 Lakeshore Surgical Consultants, Plc Surgery 5400 Fort St, Suite 200, Trenton, MI 48183-4632 2014-02-26
1346514254 Masih Abdul Kader Surgery 3901 Beaubien St, Detroit, MI 48201-2119 2012-02-24
1730324096 Lydia Joy Donoghue Surgery 3901 Beaubien St, Dept of Pediatric Surgery, Detroit, MI 48201-2119 2008-12-15
1194920041 Justin D Klein Surgery 3901 Beaubien St, Carls Building 2nd Floor, Detroit, MI 48201-2119 2007-06-20
1366597544 Covenant Medical Center, Inc. Surgery 1447 N Harrison St, Saginaw, MI 48602-4727 2007-01-25
1780780478 Juda Z Jona Surgery 1200 E Michigan Ave, Suite 460, Lansing, MI 48912-1800 2006-09-16
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Competitor

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City GRAND RAPIDS
Zip Code 49503

Improve Information

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Dataset Information

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.

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