Individual provider Active NPI

Penny Penland Stollery, ANP-C

  • Adult Health Nurse Practitioner
  • Elmira, NY
National Provider Identifier
1033295100
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
312296 Issued in NY
Practice address
600 Roe Ave
Elmira, NY 14905-1676
Phone
(607) 737-8165
Fax
(607) 737-8175
NPI assigned
Oct 31, 2006
Last updated
Jun 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5002050 NC
Nurse Practitioner 363L00000X 312296 NY
Adult Health Nurse Practitioner 363LA2200X 5015712 NC
Adult Health Nurse Practitioner 363LA2200X 312296 NY Primary

Addresses

Primary practice location

600 Roe Ave
Elmira, NY 14905-1676

Mailing address

600 Ivy St Ste 206
Elmira, NY 14905-1627
Phone (607) 271-2050

Other practice location 1

571 S Allen Rd
Flat Rock, NC 28731-9447
Phone (828) 692-6178

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pstollery@fourseasonscfl.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070406000351 NC Practitioner - Nurse Practitioner 2365546058
I20250710001127 NY Practitioner - Nurse Practitioner 2365546058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cayuga Medical Center at IthacaGroup PAC ID 7214847367, 34 clinicians
Arnot Ogden Medical CenterGroup PAC ID 5395798417, 219 clinicians

Practice addresses (Care Compare)

101 Dates Dr
Ithaca, NY 14850-1342
Phone (607) 274-4443

600 Roe Ave
Elmira, NY 14905-1629
Phone 60773741004118

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
312296NYMDInternal Medicine Physician
5002050NCMDNurse Practitioner
5015712NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arnot Ogden Medical Center CurrentSince Jul 7, 2025 Accepting new patients
Cayuga Medical Center at Ithaca CurrentSince Jul 7, 2025 Accepting new patients
Cayuga Pathology PLLC Current Accepting new patients
Cayuga Medical Center at Ithaca CurrentSince Jul 7, 2025 Accepting new patients
Arnot Ogden Medical Center CurrentSince Jul 7, 2025 Accepting new patients
Cancer Care of WNC Past Accepting new patients
Cayuga Medical Center at Ithaca Past Accepting new patients
Cancer Care of WNC, PA Past Accepting new patients
Arnot Medical Services PLLC Past Accepting new patients

Locations

600 Roe Ave
Elmira, NY 14905
Phone (607) 733-3639

600 Roe Ave
Ste 1F
Elmira, NY 14905
Phone (607) 795-8161

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

Organizations & group practices 9

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

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1033295100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 IVY ST STE 206",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149051627",
            "telephone_number": "607-271-2050",
            "fax_number": "607-271-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ROE AVE",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149051676",
            "telephone_number": "607-737-8165",
            "fax_number": "607-737-8175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "571 S Allen Rd",
            "address_purpose": "LOCATION",
            "city": "Flat Rock",
            "state": "NC",
            "postal_code": "287319447",
            "country_code": "US",
            "telephone_number": "828-692-6178",
            "fax_number": "828-692-2365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOLLERY",
        "first_name": "PENNY",
        "middle_name": "PENLAND",
        "name_prefix": "Mrs.",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5002050",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "312296",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5015712",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "312296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pstollery@fourseasonscfl.org",
            "affiliation": "N",
            "address_1": "571 S Allen Rd",
            "city": "Flat Rock",
            "state": "NC",
            "country_code": "US",
            "postal_code": "287319447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.