MISS JODY LYNN PENNYCOOK PA
NPI 1255696910
Physician Assistant - Medical in Santa Rosa, CA
NPI Status: Active since July 09, 2012
Contact Information
4740 HOEN AVE
SANTA ROSA, CA
ZIP 95405
Phone: (707) 542-2783
Fax: (707) 542-7976
- Individual
- Female
- Physician Assistant
- Medical
- PECOS Enrolled
About JODY PENNYCOOK
This page provides the complete NPI Profile along with additional information for Jody Pennycook, a primary care provider established in Santa Rosa, California with a medical specialization in Physician Assistant, focusing in medical . The healthcare provider is registered in the NPI registry with number 1255696910 assigned on July 2012. The practitioner's primary taxonomy code is 363AM0700X with license number PA22225 (CA). The provider is registered as an individual and her NPI record was last updated 13 years ago.
- NPI
- 1255696910
- Provider Name
- MISS JODY LYNN PENNYCOOK PA
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 4740 HOEN AVE SANTA ROSA, CA 95405
- Location Phone
- (707) 542-2783
- Location Fax
- (707) 542-7976
- Mailing Address
- 4740 HOEN AVE SANTA ROSA, CA 95405
- Mailing Phone
- (707) 542-2783
- Mailing Fax
- (707) 542-7976
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 07-09-2012
- Last Update Date
- 07-09-2012
- Code Navigator
A primary care provider (PCP) like Jody Pennycook sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Medical
- Taxonomy Code
- 363AM0700X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- PA22225
- License State
- CA
Medicare Participation & PECOS Enrollment Status
Jody Pennycook is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 5 | 5 | 6 | 9 | 6 | 9 | 1 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 10 | 5 | 12 | 9 | 12 | 9 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 0 + 5 + 1 + 2 + 9 + 1 + 2 + 9 + 2 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1255696910 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1811074586 | DR. SANJAY CHAMANLAL DHAR MD Individual | Internal Medicine (Cardiovascular Disease) | 4740 HOEN AVE SANTA ROSA, CA 95405 (707) 542-2783 |
| 1881771566 | NORTH BAY CARDIAC IMAGING INC Organization | Nuclear Medicine (Nuclear Imaging & Therapy) | 4740 HOEN AVE SUITE B SANTA ROSA, CA 95405 (707) 636-5550 |
| 1114099884 | NORTH BAY CARDIOLOGY INC. Organization | Internal Medicine (Cardiovascular Disease) | 4740 HOEN AVE SANTA ROSA, CA 95405 (707) 542-2783 |
| 1821160599 | DR. STEPHEN WAYNE HALPERN MD Individual | Internal Medicine (Cardiovascular Disease) | 4740 HOEN AVE SANTA ROSA, CA 95405 (707) 542-2783 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1255696910, enumerated in the NPI registry as an "individual" on July 09, 2012
The provider is located at 4740 Hoen Ave Santa Rosa, Ca 95405 and the phone number is (707) 542-2783
The provider's speciality is Physician Assistant with taxonomy code 363AM0700X with a focus in Medical
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.
This NPI record was last updated on July 09, 2012. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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