Phillip C Penny (NPI# 1326311481, PAC ID# 5395013890) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1326311481 |
| PAC ID by PECOS | 5395013890 |
| Professional Enrollment ID | I20170623001323 |
| Full Name | Phillip C Penny |
| Organization Legal Name | FORT WAYNE ORTHOPAEDICS, LLC |
| Address |
605 N Walnut St North Manchester IN 46962-1857 |
| Phone Number | 2604368686 |
| Gender | M |
| Medical School | LINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT |
| Graduation Year | 2012 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 7618965286 |
| Number of Group Practice Members | 47 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150133 | KOSCIUSKO COMMUNITY HOSPITAL |
| 150168 | THE ORTHOPAEDIC HOSPITAL OF LUTHERAN HEALTH NETWOR |
| 150017 | LUTHERAN HOSPITAL OF INDIANA |
| 150047 | ST JOSEPH HOSPITAL |
| 150101 | PARKVIEW WHITLEY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 605 N Walnut St, North Manchester, IN 46962-1857 | 2604368686 | FORT WAYNE ORTHOPAEDICS, LLC |
| Organization Legal Name | FORT WAYNE ORTHOPAEDICS, LLC |
| Physicians | 49 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Abigail Vanlaningham | Physician Assistant | Fort Wayne Orthopaedics, LLC | 3270 Intertech Dr, Angola, IN 46703-7325 |
| Matthew A Bohren | Physician Assistant | Fort Wayne Orthopaedics, LLC | 217 W Wayne St, Fort Wayne, IN 46802-3605 |
| Hope E Royce | Nurse Practitioner | Fort Wayne Orthopaedics, LLC | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 |
| Gage M Caudell | Podiatry | Fort Wayne Orthopaedics, LLC | 208 N Columbus St, Hicksville, OH 43526-1250 |
| Brian T Laursen | Physician Assistant | Fort Wayne Orthopaedics, LLC | 701 Orthopaedic Dr, Suite 100, Warsaw, IN 46582-3905 |
| Jonathan D Detommaso | Podiatry | Fort Wayne Orthopaedics, LLC | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 |
| Ian R Nelson | Orthopedic Surgery | Fort Wayne Orthopaedics, LLC | 2512 E Dupont Rd, Suite 110, Fort Wayne, IN 46825-1609 |
| John Paul Magno Manalo | Orthopedic Surgery | Fort Wayne Orthopaedics, LLC | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 |
| Alex Villavicencio | Nurse Practitioner | Fort Wayne Orthopaedics, LLC | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 |
| Carolyn Hanrahan | Physician Assistant | Fort Wayne Orthopaedics, LLC | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 |
| Street Address |
605 N WALNUT ST |
| City | NORTH MANCHESTER |
| State | IN |
| Zip | 46962-1857 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eric D Reichenbach | Family Medicine | Parkview Wabash Hospital Inc | 1104 N Wayne St, Parkview Wabash Health Clinic North Manchester, North Manchester, IN 46962-1001 |
| Bradley S Camp | Optometry | 103 Front St, North Manchester, IN 46962-1529 | |
| Joel Harman | Chiropractic | 110 N Walnut St, North Manchester, IN 46962-1844 |
| City | NORTH MANCHESTER |
| Zip Code | 46962 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | NORTH MANCHESTER + ORTHOPEDIC SURGERY |
Please comment or provide details below to improve the information on Phillip C Penny.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.