Penan Partnership

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

109836 Issued in TX

Legal business name

PENAN PARTNERSHIP

Doing business as

Pebble Creek Nursing Center

Practice address

11608 Scott Simpson Dr
El Paso, TX 79936-6210

Phone

(915) 857-0071

Fax

(915) 857-0118

NPI assigned

Jul 1, 2005

Organization subpart

No

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

Authorized official

Name

Michael Perkins, LNFA

Title

Administrator

Phone

(915) 857-0071

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pebble Creek Nursing Center Doing business as

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1063419323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11608 SCOTT SIMPSON DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799366210",
            "telephone_number": "915-857-0071",
            "fax_number": "915-857-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11608 SCOTT SIMPSON DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799366210",
            "telephone_number": "915-857-0071",
            "fax_number": "915-857-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENAN PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-01",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "PERKINS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "915-857-0071",
        "authorized_official_credential": "LNFA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "109836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5239",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pebble Creek Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rosella Pena
• Sarah Pena
• Jasmin Penafiel
• Laura Penafiel, ACNPC-AG
• Angel Penaloza, LPC-A
• Penan Retirement Centers Limited Partnership (The Bartlett Skilled Nursing and Assisted Living)
• Eribeth K Penaranda, M.D.
• Yolanda L Pender
• Florentino Ray Penilla, PHARMACIST
• Shelbie Ann Penner, RD, LD

• Skilled Nursing Facility in El Paso, TX
• Providers in El Paso, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.