Jared R. Pennington, PA-C
Physician Assistant in Minneapolis, MN. Individual provider (NPI-1).
NPI number1346205697
StatusActive
Last updated in NPPESOct 16, 2025
Details
- NPI
- 1346205697
- Entity type
- Individual (NPI-1)
- Name
- Jared R. Pennington
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 19, 2006
- Certification date
- Oct 16, 2025
- Last updated
- Oct 16, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 15436 | MN | Yes |
| 363A00000X | Physician Assistant | 50.002588 | OH |
Practice location
2925 Chicago AveMinneapolis, MN 55407-1321
Phone 612-262-9000
Mailing address
2925 Chicago AveMinneapolis, MN 55407-1321
Phone 612-262-5000
Other practice locations
1 Perkins Sq
Akron, OH 44308-1063
Akron, OH 44308-1063
Phone 330-543-8050 · Fax 330-543-8054
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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