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JAMES EARL PENNOYER IV
NPI 1205413853
Student in an Organized Health Care Education/Training Program in Atlanta, GA

Active since March 28, 2021PECOS EnrolledAccepts Medicare Assignment
49 JESSE HILL JR DR SE, ATLANTA, GA 30303(404) 778-7777 Get Directions Write a Review

NPPES record last updated: March 28, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About James Earl Pennoyer Iv NPPES

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

JAMES EARL PENNOYER IV (NPI 1205413853) is an individual student in an organized health care education/training program in Atlanta, Georgia and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS and is a graduate of Medical College Of Georgia School Of Medicine (2021).

NPPES Registry Identity

NPI1205413853
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJAMES EARL PENNOYER IV
Location Address49 JESSE HILL JR DR SEAtlanta, GA 30303-3049
Mailing Address49 Jesse Hill Jr Dr SeAtlanta, GA 30303-3049
Phone(404) 778-7777
Sole ProprietorYes
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 2021
Enumeration DateMarch 28, 2021
NPPES CertifiedMarch 28, 2021
✔ NPI 1205413853 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.
49 JESSE HILL JR DR SE, Atlanta, GA 30303
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

James Earl Pennoyer Iv is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800297995
PECOS Enrollment IDI20240709000165
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.

Medicare Billing Reassignments

2

Medicare enrollment records show James Pennoyer reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Emory Medical Care Foundation Inc
0.1 mi
Physical Medicine & Rehabilitation
80 JESSE HILL JR DR SE
Atlanta, GA 30303
  • Reassigned Medicare billing, Georgia enrollment
  • 2,681 clinicians in this Medicare group
NPI 1063678563 (404) 778-5014
The Emory Clinic Inc
4.4 mi
Internal Medicine
1365 CLIFTON RD NE
Atlanta, GA 30322
  • Reassigned Medicare billing, Georgia enrollment
  • 4,840 clinicians in this Medicare group
NPI 1396798229 (404) 778-2144

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

CAMERON R MARTIN PA-C
Physician Assistant
49 JESSE HILL JR DR SE
ATLANTA, GA 30303
Fulton County (404) 616-4473
JOO YOUNG JUNG
Student in an Organized Health Care Education/Training Program
49 JESSE HILL JR DR SE
ATLANTA, GA 30303
Fulton County (404) 778-7777
SUMAIYA ALAM MD
Student in an Organized Health Care Education/Training Program
49 JESSE HILL JR DR SE
ATLANTA, GA 30303
Fulton County (404) 778-7777
SHRUTI GUPTA MD
Internal Medicine (Hematology & Oncology)
49 JESSE HILL JR DR SE
ATLANTA, GA 30303
Fulton County (404) 778-7777
NANDINI AVULA
Student in an Organized Health Care Education/Training Program
49 JESSE HILL JR DR SE
ATLANTA, GA 30303
Fulton County (404) 778-7777
WASEF NIJIM
Student in an Organized Health Care Education/Training Program
49 JESSE HILL JR DR SE
ATLANTA, GA 30303
Fulton County (404) 778-7777
CHANDRIKA SANAPALA DO
Student in an Organized Health Care Education/Training Program
49 JESSE HILL JR DR SE
ATLANTA, GA 30303
Fulton County (404) 778-7777
DR. DAMON LEE JONES III M.D.
Pediatrics
49 JESSE HILL JR DR SE
ATLANTA, GA 30303
Fulton County (404) 778-1440

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 James Pennoyer's NPI number?

The NPI number for James Pennoyer is 1205413853. It was assigned to this individual provider in the NPPES registry on March 28, 2021.

Where is James Pennoyer located?

James Pennoyer practices at 49 Jesse Hill Jr Dr SE, Atlanta, GA 30303. The listed phone number is (404) 778-7777.

What is James Pennoyer's specialty?

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

Is James Pennoyer enrolled in Medicare?

Yes. James Pennoyer is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for James Pennoyer's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Pennoyer reassigns Medicare benefits to 2 organizations: Emory Medical Care Foundation Inc (Atlanta, GA) and The Emory Clinic Inc (Atlanta, GA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for James Pennoyer's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for James Pennoyer was last updated on March 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.