Individual provider Active NPI

Penni Hargrove, RN

  • Emergency Registered Nurse
  • Carrollton, TX
National Provider Identifier
1093529554
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
941230 Issued in TX
Practice address
2004 Lorient Dr
Carrollton, TX 75007-2320
Phone
(469) 491-7705
NPI assigned
Feb 5, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 941230 TX Primary

Addresses

Primary practice location

2004 Lorient Dr
Carrollton, TX 75007-2320

Mailing address

2004 Lorient Dr
Carrollton, TX 75007-2320
Phone (469) 491-7705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
941230TXMDEmergency Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1738713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1093529554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 LORIENT DR",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750072320",
            "telephone_number": "469-491-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 LORIENT DR",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750072320",
            "telephone_number": "469-491-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGROVE",
        "first_name": "PENNI",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "TX",
            "license": "941230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.