Individual provider Active NPI

Allison Leigh Penny, APRN

  • Pediatric Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1003475211
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN9367136 Issued in FL
Practice address
615 E Princeton St Ste 510
Orlando, FL 32803-1424
Phone
(407) 898-1210
Fax
(407) 898-2909
NPI assigned
Jun 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN9367136 FL Primary

Addresses

Primary practice location

615 E Princeton St Ste 510
Orlando, FL 32803-1424

Mailing address

PO Box 691597
Orlando, FL 32869-1597
Phone (407) 898-1210

Other practice location 1

200 E Marks St
Orlando, FL 32803-3819
Phone (407) 284-6460

Other identifiers 1

IdentifierTypeStateIssuer
PC866OtherFLFL HF MA

Other names 1

  • Allison Leigh Bombalier Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9367136FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carrasquero Pediatrics and Associates Past Accepting new patients
Privia Medical Group Florida, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: allison.penny.1@8042.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1003475211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 691597",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328691597",
            "telephone_number": "407-898-1210",
            "fax_number": "407-898-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E PRINCETON ST STE 510",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031424",
            "telephone_number": "407-898-1210",
            "fax_number": "407-898-2909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 E Marks St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328033819",
            "country_code": "US",
            "telephone_number": "407-284-6460",
            "fax_number": "407-284-6461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENNY",
        "first_name": "ALLISON",
        "middle_name": "LEIGH",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-11",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN9367136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL HF MA",
            "identifier": "PC866",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLISON",
            "last_name": "BOMBALIER",
            "middle_name": "LEIGH",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.