Individual provider Active NPI

Natalie Christine Penn, M.D.

  • Pediatrics Physician
  • Denver, CO
National Provider Identifier
1073924130
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DR.0059103 Issued in CO
Practice address
2650 18TH St
Ste 100
Denver, CO 80211
Phone
(720) 583-4470
Fax
(888) 463-5887
NPI assigned
May 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X DR.0059103 CO Primary
Pediatrics Physician 208000000X A176042 CA

Addresses

Primary practice location

2650 18TH St
Ste 100
Denver, CO 80211

Mailing address

2650 18TH St
Ste 100
Denver, CO 80211
Phone (720) 583-4470

Other practice location 1

4815 Watt Ave
North Highlands, CA 95660-5108
Phone (916) 454-2345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190617000642 NM Practitioner - Pediatric Medicine 0143553636 Reassigns benefits to 1 organization
I20230202001845 CA Practitioner - Pediatric Medicine 0143553636 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A176042CAMDPediatrics Physician
DR.0059103COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peach Tree Healthcare Pediatrics CurrentSince Oct 1, 2023 Accepting new patients
St Vincent Hospital Current Accepting new patients
Peach Tree Healthcare CurrentSince Oct 1, 2023 Accepting new patients
St. Vincent Hospital CurrentSince May 27, 2019 Accepting new patients
St. Vincent Hospital CurrentSince May 27, 2019 Accepting new patients
Highlands Integrative Pediatics, PC Pediatrics Past Accepting new patients

Locations

9980 Live Oak Blvd
Live Oak, CA 95953
Phone (503) 749-3242

1114 Yuba St
Ste 220
Marysville, CA 95901
Phone (240) 816-4358

5730 Packard Ave
Ste 500
Marysville, CA 95901
Phone (530) 399-0217

3810 Rosin Ct
Ste 100
Sacramento, CA 95834
Phone (530) 413-9627

1275 Tharp Rd
Yuba City, CA 95993

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: natalie.penn.p1@direct.peachtreehealth.nextgenshare.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1073924130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 18TH ST",
            "address_2": "STE 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80211",
            "telephone_number": "720-583-4470",
            "fax_number": "888-463-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 18TH ST",
            "address_2": "STE 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80211",
            "telephone_number": "720-583-4470",
            "fax_number": "888-463-5887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4815 Watt Ave",
            "address_purpose": "LOCATION",
            "city": "North Highlands",
            "state": "CA",
            "postal_code": "956605108",
            "country_code": "US",
            "telephone_number": "916-454-2345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENN",
        "first_name": "NATALIE",
        "middle_name": "CHRISTINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-12",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0059103",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A176042",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.