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Active NPI 1053877159 Individual Practitioner Male Practitioner

Dr. Blake Robert Pennock , DC

Chiropractor • Flagstaff, AZ

Professional Overview & Biography Verified Profile Summary

Dr. Blake Pennock, DC is a registered healthcare professional specializing in Chiropractor in Flagstaff, AZ. Practice services are available at 1501 S YALE ST STE 250 under active NPI credentials.

Frequently performed procedures and clinical services include chiropractic manipulative treatment, 3-4 spinal regions. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1501 S Yale St Ste 250

Flagstaff, AZ 860017336

Telephone 9285570707
Associated Practice Facility / Clinic
🏢 Naz Mua Llc Facility NPI 1457173312

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Flagstaff, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 23.0 Yrs
State Avg: 26.0 Yrs
Regional Practice Density
39 Specialists

Practicing in Flagstaff, AZ (2102 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
41.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
98941 Chiropractic manipulative treatment, 3-4 spinal regions
86 26 $69.00 $40.58

Medical Specialties & State Licenses

Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License AZ 8787

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1194961193

Doctor of Chiropractic

Melissa Carone , NP-C

Nurse Practitioner - Family

NPI 1255844411

Nurse Practitioner (Certified)

NPI 1295085348

Doctor of Chiropractic

Cynthia Adson , ARNP, FNP-BC

Nurse Practitioner - Family

NPI 1407500705

Advanced Registered Nurse Practitioner, Family Nurse Practitioner (Board Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active February 22, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location February 22, 2019

Registered at 1501 S YALE ST STE 250, FLAGSTAFF, AZ 860017336 (Tel: 9285570707)

📍
Updated Business Mailing Address February 22, 2019

Registered at 505 W BASELINE RD APT 2142, TEMPE, AZ 852835319 (Tel: 5632497446)

👤
Provider Name / Credentials Updated February 22, 2019

Recorded as BLAKE PENNOCK, DC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 22, 2019

Chiropractor (License #8787 in AZ)

🟢
Initial NPI Registration & Enumeration February 13, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1053877159
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 13, 2019
Last Update: February 22, 2019
Sole Proprietor: Yes

Mailing Address

505 W Baseline Rd Apt 2142

Tempe, AZ 852835319

Phone: 5632497446

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.