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JACKSON PENNING
NPI 1194467308
Student in an Organized Health Care Education/Training Program in Minneapolis, MN

Active since April 08, 2022PECOS Enrolled
420 DELAWARE STREET SE, MMC 292, MINNEAPOLIS, MN 55455(612) 626-5589 Get Directions Write a Review

NPPES record last updated: May 13, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 13, 2024, Jun 7, 2023, Apr 8, 2022 (3 updates tracked since 2022).

About Jackson Penning NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKSON PENNING (NPI 1194467308) is an individual student in an organized health care education/training program in Minneapolis, Minnesota and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194467308
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACKSON PENNING
Location Address420 DELAWARE STREET SE, MMC 292Minneapolis, MN 55455
Mailing Address420 Delaware St SeMinneapolis, MN 55455-0341 · (612) 626-5589
Phone(612) 626-5589
Sole ProprietorNo
Enumeration DateApril 8, 2022
Last NPPES UpdateMay 13, 20243 updates tracked since enumeration
NPPES CertifiedMay 13, 2024
✔ NPI 1194467308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
420 DELAWARE STREET SE, Minneapolis, MN 55455
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jackson Penning is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROSS RYBAKOWICZ MD
Student in an Organized Health Care Education/Training Program
420 DELAWARE STREET SE, MMC 195
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-6483
ANOOJ PATEL
Student in an Organized Health Care Education/Training Program
420 DELAWARE STREET SE, MMC 195
MINNEAPOLIS, MN 55455
Hennepin County (612) 624-4777
SUCHAPA ARAYAKARNKUL M.D.
Student in an Organized Health Care Education/Training Program
420 DELAWARE STREET SE, MMC 284
MINNEAPOLIS, MN 55455
Hennepin County (612) 626-5454
DR. BOYANGZI LI MD, PHD
Internal Medicine (Cardiovascular Disease)
420 DELAWARE STREET SE, MMC 508
MINNEAPOLIS, MN 55455
Hennepin County (612) 626-2589
DR. JACQUELINE TUCKER MD
Student in an Organized Health Care Education/Training Program
420 DELAWARE STREET SE, MMC 396
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-7692
NEUROLOGY LTD.
Clinical Medical Laboratory
420 DELAWARE STREET SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-1431
CHESNEY BURGWEGER SIEMS MD
Surgery
420 DELAWARE STREET SE, MMC 195
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-6483
SANA KAGALWALLA
Student in an Organized Health Care Education/Training Program
420 DELAWARE STREET SE, MMC 284
MINNEAPOLIS, MN 55455
Hennepin County (612) 626-5454

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackson Penning's NPI number?

The NPI number for Jackson Penning is 1194467308. It was assigned to this individual provider in the NPPES registry on April 8, 2022.

Where is Jackson Penning located?

Jackson Penning practices at 420 Delaware Street SE Mmc 292, Minneapolis, MN 55455. The listed phone number is (612) 626-5589.

What is Jackson Penning's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jackson Penning enrolled in Medicare?

Yes. Jackson Penning is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jackson Penning was last updated on May 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.