Individual provider Active NPI

Allison Lane Penny, FNP-C

  • Family Nurse Practitioner
  • Walker, LA
National Provider Identifier
1073344131
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
234914 Issued in LA
Practice address
5000 Odonavan Blvd Ste 404
Walker, LA 70785-6355
Phone
(225) 369-8100
Fax
(225) 369-8140
NPI assigned
Aug 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X AP234914 LA
Family Nurse Practitioner 363LF0000X 234914 LA Primary

Addresses

Primary practice location

5000 Odonavan Blvd Ste 404
Walker, LA 70785-6355

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 369-8100

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address apenny5299836@direct.casso.us.com Direct
Other URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241111003542 LA Practitioner - Nurse Practitioner 4688108806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5000 Odonavan Blvd
Walker, LA 70785-6351
Phone (225) 214-4200

7777 Hennessy Blvd
Baton Rouge, LA 70808-4363

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP234914LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Sep 23, 2024 Accepting new patients
Our Lady of the Lake Physician Group LLC Single Specialty Current Accepting new patients
Our Lady of the Lake Physician Group, LLC CurrentSince Sep 23, 2024 Accepting new patients
Our Lady of the Lake Physician Group LLC Single Specialty Past Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

5000 Odonavan Blvd
Ste 404
Walker, LA 70785
Phone (225) 369-8100

Organizations & group practices 4

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 1

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": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1073344131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-369-8100",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 ODONAVAN BLVD STE 404",
            "city": "WALKER",
            "state": "LA",
            "postal_code": "707856355",
            "telephone_number": "225-369-8100",
            "fax_number": "225-369-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNY",
        "first_name": "ALLISON",
        "middle_name": "LANE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "AP234914",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "234914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apenny5299836@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "apenny5299836@direct.casso.us.com",
            "address_1": "5000 Odonavan Blvd Ste 404",
            "city": "Walker",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707856355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5000 Odonavan Blvd Ste 404",
            "city": "Walker",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707856355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Walker, LA

Sources for this page

Verify at the official NPI Registry.