DR. CONNIE JO PENNINGTON (M.D.) – Surgery Physician, NPI 1790783330
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
37 COLORECTAL SURGERY (PROCTOLOGY) in TN
Provider Addresses for DR. CONNIE JO PENNINGTON (M.D.)
1 TALLAPOOSA RD
JOHNSON CITY, TN 376047187
Phone: (423) 534-9029
Type: Mailing
Knob Creek Rd, Camelot, Johnson City, Washington County, Tennessee, 37604, United States
SUITE 100
JOHNSON CITY, TN 376042366
Phone: (423) 610-1177
Fax: (423) 610-1179
Type: Mailing
800 S GAY ST STE 100
KNOXVILLE, TN 379294040
Phone: (423) 534-9029
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $103.
Total Amount is formed as General ($103) + Research ($0) + Ownership ($0) = $103.
Last reported payment date: 2024-10-15 • Largest payer in this snapshot: Urgo Medical North America, LLC ($53).
Total Amount
$103
General + Research + Ownership
Payments
6
Total payment records
General Amount
$103
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Urgo Medical North America, LLC | $53 |
| Medtronic, Inc. | $19 |
| ABBVIE INC. | $18 |
| ConvaTec Inc. | $13 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2008-03-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080321000146 | I | Colorectal Surgery (Proctology) | TN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 359 | 165 | $0 |
| 99211 | Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | 65 | 62 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 56 | 56 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 43 | 37 | $0 |
| 45380 | Biopsy of large bowel using a flexible endoscope | 33 | 33 | $0 |
Insurance plans in this area (ZIP 37604)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| COLORECTAL SURGERY (PROCTOLOGY) | TN | 46600 | Diagnostic examination of the anus using an endoscope | 17 | 16 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O L O G Y | MD | |
| Physician Assistant | TN | |
| - | VA | |
| - | TN | |
| Anesthesiology, Pain Management | TN | |
| Pediatric Medicine | TN | |
| - | VA | |
| N E P H R O L O G Y | VA | |
| Physician Assistant | TN | |
| - | TN |
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