DR. JUSTIN DAVID PENNINGTON (NPI# 1285293233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285293233 |
| Entity Type | Individual |
| Full Name | DR. JUSTIN DAVID PENNINGTON |
| Credential | MD |
| Practice Address |
593 Eddy St Providence RI 02903-4923 |
| Practice Telephone | 4014444669 |
| Practice Fax Number | 4014447076 |
| Mailing Telephone | 4014444669 |
| Mailing Fax Number | 4014447076 |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2020-06-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | LP04910 | RI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 680 Centre St, Brockton, MA 023023395 | 5089417000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225523582 | Justin Paul Pennington | Dentist | 28 Butler St, Midway, GA 31320-4294 | 2018-06-28 |
| 1457832123 | Justin Scott Pennington | Physical Therapist | 136 Bristol East Rd, Bristol, VA 24202 | 2018-08-22 |
| Street Address |
593 EDDY ST |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02903-4923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952306185 | Mitchel A Sklar | Internal Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2005-06-15 |
| 1376140707 | Kristen Marie Czekanski | Student in an Organized Health Care Education/Training Program | 593 Eddy St, Providence, RI 02903-4923 | 2020-10-08 |
| 1326645300 | Elizabeth Stefanilo | Nurse Practitioner | 593 Eddy St, Providence, RI 02903-4923 | 2020-10-03 |
| 1841807633 | Julie Walden | Student in an Organized Health Care Education/Training Program | 593 Eddy St, Providence, RI 02903-4923 | 2020-09-26 |
| 1417567751 | Yigit Baykara | Pathology | 593 Eddy St, Providence, RI 02903-4923 | 2020-08-02 |
| 1588273064 | Cassandra Pagnotta | Dietitian, Registered | 593 Eddy St, Providence, RI 02903-4923 | 2020-07-30 |
| 1982213294 | Sabitha Sasidharan Pillai | Pediatrics | 593 Eddy St, Providence, RI 02903-4923 | 2020-07-23 |
| 1861019481 | Courtney Pedersen | Emergency Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2020-06-30 |
| 1508483496 | Mohammad Hisham Hout | Urology | 593 Eddy St, Providence, RI 02903-4923 | 2020-06-26 |
| 1639796642 | Benjamin Hagan | Emergency Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2020-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475755 | Sarah Fellows | Student in an Organized Health Care Education/Training Program | 350 Eddy Street, Uri Nursing Education Center, Providence, RI 02903 | 2020-10-20 |
| 1093328262 | Esther Robbins | Social Worker | 290 West Exchange St., Suite 100, Providence, RI 02903 | 2020-08-27 |
| 1720619489 | Ivy Marie Mcdonald | Behavioral Analyst | 290 W Exchange St #101, Providence, RI 02903 | 2020-01-31 |
| 1447802707 | Natalie Monaghan, LLC | Social Worker | 545 South Water Street, Providence, RI 02903 | 2019-07-16 |
| 1760049522 | Daniel Steven Alanko | Pediatrics | 293 Eddy Street, Providence, RI 02903 | 2019-05-28 |
| 1154894368 | Margaret Emily Dyson | Behavior Technician | 290 W. Exchange St, Providence, RI 02903 | 2019-01-10 |
| 1497235014 | Yao Zhou Liu | Surgery | 593 Eddy St - Rhode Island Hospital, Providence, RI 02903 | 2018-08-14 |
| 1558840645 | Tamara Gore | Behavior Technician | 290 W Exchange Street Suite 101, Providence, RI 02903 | 2018-08-09 |
| 1437642709 | Adrian Cotarelo | Student in an Organized Health Care Education/Training Program | 174 Wickenden St, Apt. 3rd Floor, Providence, RI 02903 | 2018-06-12 |
| 1356833024 | Natalie Rita Noonan | Clinical Neuropsychologist | 593 Eddy St Ste 430, Providence, RI 02903 | 2018-05-30 |
| Find all providers in zip 02903 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316265259 | Melissa Ann Simon | Ophthalmology | 2 Dudley St Ste 505, Providence, RI 02905-3249 | 2010-05-16 |
| 1023268018 | Irene M Lee Md PC | Ophthalmology | 903 Providence Pl, Apartment 362, Providence, RI 02903-7000 | 2008-09-25 |
| 1548426661 | Nicholas Dushku | Ophthalmology | 338 Choke Cherry Ln, Providence, UT 84332-9513 | 2008-07-29 |
| 1174670806 | King Wai To | Ophthalmology | One Hoppin Street, Suite 202, Providence, RI 02903-4141 | 2007-01-04 |
| 1659310738 | Andrew Ginn Bong Young | Ophthalmology | 1 Hoppin St Ste 202, Providence, RI 02903-4141 | 2006-06-05 |
| 1710950142 | Philip R Rizzuto | Ophthalmology | 120 Dudly St, Suite 301, Providence, RI 02905 | 2006-02-08 |
| 1972589745 | Robert Jeffrey Hofmann | Ophthalmology | 150 East Manning St., Providence, RI 02906 | 2005-12-22 |
| 1033109111 | Jason Edward Karo | Ophthalmology | 150 E Manning St, Providence, RI 02906-5109 | 2005-10-28 |
| 1538154703 | Yoash R Enzer | Ophthalmology | 120 Dudley St, Suite 104, Providence, RI 02905-2436 | 2005-09-14 |
| 1467458331 | Paul B Greenberg | Ophthalmology | One Randall Square, Suite 203, Providence, RI 02904-4928 | 2005-06-24 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02903 |
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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.