Philip Penn, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3017636 Issued in KY

Practice address

3300 Tates Creek Rd
Lexington, KY 40502-3408

Phone

(859) 266-2126

Fax

(859) 266-5353

NPI assigned

May 24, 2022

Last updated

May 24, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Philip Tyler Penn Professional name

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Abode Care Partners LTC VB LLCGroup PAC ID 8325316516, 81 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Abode Care Partners LTC VB, LLC

  • Nurse Practitioner
  • Louisville, KY
  • NPI 1447029798
  Medicare reassignment Care Compare group NPD
• Abode Care Partners Al VB, LLC

  • Nurse Practitioner
  • Louisville, KY
  • NPI 1992574354
  Medicare reassignment NPD
• Cogent Healthcare of Kentucky, PSC

  • Internal Medicine Physician
  • Lexington, KY
  • NPI 1053362293
  Medicare reassignment NPD
• SHC Medical Partners of Kentucky, LLC

  • Nurse Practitioner
  • Louisville, KY
  • NPI 1417132614
  Medicare reassignment NPD
• Abode Care Partners Al VB, LLC

  • Nurse Practitioner
  • Texarkana, TX
  • NPI 1528871126
  NPD
• Abode Care Partners LTC VB, LLC

  • Nurse Practitioner
  • Ridgeland, MS
  • NPI 1992518591
  NPD

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1124766738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 BLUEGRASS PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 TATES CREEK RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405023408",
            "telephone_number": "859-266-2126",
            "fax_number": "859-266-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "PHILIP",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3017636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHILIP",
            "last_name": "PENN",
            "middle_name": "TYLER",
            "prefix": "MR.",
            "credential": "APRN, FNP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Chasity Pendleton, APRN, FNP-C
• Jessica Pendleton, APRN, PMHNP-BC
• Julie Rene Penn
• Lindsay Atherton Penn, PA-C
• Marsha K Penn, MD
• Bridget J. Pennell, APRN
• Beth A Penney
• Abby L Pennington, PA-C
• Alesha Gail Pennington, APRN
• Caitlin Erin Pennington, PA-C

• Family Nurse Practitioner in Lexington, KY
• Providers in Lexington, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.