Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Willie A Pennick, MD

Individual provider Family Medicine Physician · NPI 1568426302

Dr. Willie A Pennick, MD is a Family Practice in Jacksonville, Florida. Graduated from University of Florida College of Medicine in 1985, 41 years ago. Practices with St Vincent's Ambulatory Care Inc, a 302-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
41
Trained at
University of Florida College of Medicine
Licensed in
FL
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1760 Edgewood Ave W Ste B
Jacksonville, FL 32208-7209
Phone: (904) 358-8480
Fax: (904) 358-8460
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence ME53419 (FL)

Record details

NPI number1568426302
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 17, 2006
Last updated in NPPESJuly 2, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Graduated 1985 (41 years in practice)
Group practice St Vincent'S Ambulatory Care Inc — 302 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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