Melissa Pennant

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

298786 Issued in NY

Practice address

189 Beech St
Valley Stream, NY 11580-4903

Phone

(718) 809-9685

Fax

(718) 228-7059

NPI assigned

Feb 20, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Melissa Pennant

  • Licensed Practical Nurse
  • Valley Stream, NY
  • NPI 1437010899
  NPD Authorized official
• Melpprivatedutynur

  • Licensed Practical Nurse
  • Valley Stream, NY
  • NPI 1801598339
  NPD

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

{
    "created_epoch": "1266624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1043532864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 BEECH ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115804903",
            "telephone_number": "718-809-9685",
            "fax_number": "718-228-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 BEECH ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115804903",
            "telephone_number": "718-809-9685",
            "fax_number": "718-228-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNANT",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-20",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "298786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06335780",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Pena, OTR
• Miriam Pena
• Carlos Israel Penalva
• Peninsula Counseling Center
• Peninsula Counseling Center,Inc
• Michael Perrone, PT, DPT
• Aquaya S Perry, MHC
• Jennifer Shakuntala Persad, NP
• Minera Devi Persaud
• Shane Anand Persaud, PHARMD

• Licensed Practical Nurse in Valley Stream, NY
• Providers in Valley Stream, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.