Keith Edwin Penner, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

051810 Issued in NC

Practice address

207 Old Lexington Rd
Thomasville, NC 27360-3428

Phone

(336) 476-2586

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpenner125704@direct.novanthealth.org

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.

• Forsyth Memorial Hospital, Inc.

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1104548874

  NC

  Medicare reassignment Care Compare group NPD
• Brunswick Community Hospital, LLC

  • Certified Registered Nurse Anesthetist
  • Bolivia, NC
  • NPI 1669725198

  NC, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Gate City Anesthesia, Inc

  • Pain Medicine (Anesthesiology) Physician
  • Greensboro, NC
  • NPI 1225135361

  NC

  Medicare reassignment NPD
• Medical Park Hospital LLC

  • Specialist
  • Winston-Salem, NC
  • NPI 1003867516

  NC

  Medicare reassignment NPD
• Novant Health Clemmons Outpatient Surgery, LLC

  • Ambulatory Surgical Clinic/Center
  • Clemmons, NC
  • NPI 1528521887

  NC

  Medicare reassignment NPD
• Novant Health Kernersville Outpatient Surgery LLC

  • Ambulatory Surgical Clinic/Center
  • Kernersville, NC
  • NPI 1750892659

  NC

  Medicare reassignment NPD
• Novant Health Matthews Medical Center LLC

  • Specialist
  • Matthews, NC
  • NPI 1184782419

  NC

  Medicare reassignment NPD
• Novant Health Mint Hill Medical Center, LLC

  • Certified Registered Nurse Anesthetist
  • Charlotte, NC
  • NPI 1063910404

  NC, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Novant Health Rowan Medical Center LLC

  • Neurology Physician
  • Salisbury, NC
  • NPI 1508931544

  NC, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Novant Health Thomasville Medical Center, LLC

  • Specialist
  • Thomasville, NC
  • NPI 1033160205

  NC, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Piedmont Triad Anesthesia, PA

  • Anesthesiology Physician
  • Winston-Salem, NC
  • NPI 1467497081

  NC, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Presbyterian Sameday Surgery Center at Ballantyne LLC

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
  • NPI 1215061049

  NC

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Forsyth Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1013944974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 OLD LEXINGTON RD",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273603428",
            "telephone_number": "336-476-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 OLD LEXINGTON RD",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273603428",
            "telephone_number": "336-476-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNER",
        "first_name": "KEITH",
        "middle_name": "EDWIN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "051810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8051375",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "4630058715",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KPENNER125704@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "207 OLD LEXINGTON RD",
            "city": "THOMASVILLE",
            "state": "NC",
            "country_code": "US",
            "postal_code": "273603428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alayna Parker
• Alice Jean Parker, RN, FNP-C
• Rutu Patel, OD
• Peace Path Therapeutic & Educational Services
• Pelican Health Thomasville LLC
• Mary Perdue
• Michaela Lynn Pesta, PA-C
• Winnie Ngoc Pham, DMD
• Mathews Keecheril Philip, MD
• Matthew Phillips, DNP, FNP-C

• All providers in Thomasville, NC
• Certified Registered Nurse Anesthetist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.