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DR. JEFFREY CARL PENCE MD
NPI 1629063722
Surgery - Pediatric Surgery in Marietta, GA

Active since September 14, 2005PECOS Enrolled
175 WHITE ST NW STE 200, MARIETTA, GA 30060(943) 202-7820 Get Directions Write a Review

NPPES record last updated: July 25, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 14, 2023, Oct 23, 2021, Dec 29, 2020 and 1 more (4 updates tracked since 2019).

About Dr. Jeffrey Carl Pence Md NPPES

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

DR. JEFFREY CARL PENCE MD (NPI 1629063722) is an individual pediatric surgery provider in Marietta, Georgia, licensed in Georgia (2086S0120X) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1629063722
Entity TypeIndividualMale
Primary Taxonomy2086S0120X
Provider Legal NameDR. JEFFREY CARL PENCECredential: MD
Location Address175 WHITE ST NW STE 200Marietta, GA 30060-7901
Mailing Address213 S Jefferson St Ste 1006Roanoke, VA 24011-1713 · (540) 224-5352
Phone(943) 202-7820
Sole ProprietorNo
Enumeration DateSeptember 14, 2005
Last NPPES UpdateJuly 25, 20254 updates tracked since enumeration
NPPES CertifiedJuly 25, 2025
✔ NPI 1629063722 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
Licenses✔ Licensed in GA · 2086S0120X✔ Licensed in NC · 9500178✔ Licensed in OH · 35.092404✔ Licensed in VA · 0101277715
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
175 WHITE ST NW STE 200, Marietta, GA 30060
Open in Google Maps ↗

Secondary Practice Locations 3

Location 13333 W Tech RdMiamisburg, OH 45342-0955 · Phone (937) 641-4000 · Fax (937) 641-4500
Location 21 Childrens PlzDayton, OH 45404-1815 · Phone (937) 641-4000 · Fax (937) 641-4500
Location 34348 Electric RdRoanoke, VA 24018-0720 · Phone (540) 769-0976 · Fax (540) 857-5383

Other Identifiers 4

Medicaid2881645OH
Medicaid8912334NC
Other12334NC · Bcbs Nc
Other370015118NC · Railroad Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Blue Cross and Blue Shield of Montana, Florida Blue (BlueCross BlueShield FL) and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jeffrey Carl Pence Md 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.

Medicare Billing Reassignments

3

Medicare enrollment records show Jeffrey Pence reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Carilion Medical Center
344 mi
Dental
2017 JEFFERSON ST SW
Roanoke, VA 24014
  • Reassigned Medicare billing, Virginia enrollment
  • 1,207 clinicians in this Medicare group
NPI 1114399276 (540) 981-7128
Central Iowa Hospital Corporation
719 mi
Family Medicine
800 COLONIAL CIR, STE 200
Norwalk, IA 50211
  • Reassigned Medicare billing, Iowa enrollment
  • 545 clinicians in this Medicare group
NPI 1659322410 (515) 285-3200
Eastern Maine Medical Center
1,125 mi
General Acute Care Hospital
489 STATE ST
Bangor, ME 04401
  • Reassigned Medicare billing, Maine enrollment
  • 788 clinicians in this Medicare group
NPI 1790789147 (207) 973-7000

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 3

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

JAMES BRIAN KELLY PA-C
Physician Assistant (Medical)
175 WHITE ST NW STE 200
MARIETTA, GA 30060
Cobb County (404) 255-1933
DR. ARMAND MONSOUR SCURFIELD M.D.
Pediatrics (Sports Medicine)
175 WHITE ST NW STE 200
MARIETTA, GA 30060
Cobb County (404) 785-5437
MRS. HOLLY CHRISTINE SMITH RN, CPNP
Nurse Practitioner (Pediatrics)
175 WHITE ST NW STE 200
MARIETTA, GA 30060
Cobb County (770) 487-3330

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 Jeffrey Pence's NPI number?

The NPI number for Jeffrey Pence is 1629063722. It was assigned to this individual provider in the NPPES registry on September 14, 2005.

Where is Jeffrey Pence located?

Jeffrey Pence practices at 175 White St NW Ste 200, Marietta, GA 30060. The listed phone number is (943) 202-7820.

What is Jeffrey Pence's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Is Jeffrey Pence enrolled in Medicare?

Yes. Jeffrey Pence is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jeffrey Pence's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeffrey Pence reassigns Medicare benefits to 3 organizations: Carilion Medical Center (Roanoke, VA), Central Iowa Hospital Corporation (Norwalk, IA) and Eastern Maine Medical Center (Bangor, ME). 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 Jeffrey Pence's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jeffrey Pence accept?

Health plans from Alliant Health Plans, Inc., Blue Cross and Blue Shield of Montana, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Mountain Health CO-OP and 5 other insurers list Jeffrey Pence as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jeffrey Pence was last updated on July 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.