DR. JEFFREY C PENCE MD NPI 1629063722

NPI Information

NPI: 1629063722
Provider Name: DR. JEFFREY C PENCE, MD
Classification: Surgery - 2086S0120X
Entity Type: Individual

Specialization: Pediatric Surgery

PECOS Registration: Yes

Address:
4348 ELECTRIC RD
ROANOKE, VA
ZIP 24018
Phone: (540) 769-0976
Get Directions

DR. Jeffrey C Pence, MD is a pediatric surgery surgery in Roanoke, VA. The provider is a surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. DR. Jeffrey C Pence, MD NPI is 1629063722. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4348 ELECTRIC RD
ROANOKE, VA
ZIP 24018-720
Phone: (540) 769-0976
Fax: (540) 857-5383

The NPI 1629063722 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/14/2005 and was last updated on 2/14/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0120X	Surgery	Pediatric Surgery	9500178	NORTH CAROLINA	No
2	2086S0120X	Surgery	Pediatric Surgery	35.092404	OHIO	No
3	2086S0120X	Surgery	Pediatric Surgery	0101277715	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2881645	MEDICAID	OHIO
2	8912334	MEDICAID	NORTH CAROLINA
3	370015118	OTHER	NORTH CAROLINA	RAILROAD MEDICARE
4	12334	OTHER	NORTH CAROLINA	BCBS NC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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