Penny Talcott Mayo, RN, CDCES

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

RN00165575 Issued in WA

Practice address

1550 S Pioneer Way
Moses Lake, WA 98837-4613

Phone

(509) 793-9780

Fax

(509) 764-3246

NPI assigned

Dec 7, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: pmayo1203448@wm.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Moses Lake School District

  • Local Education Agency (LEA)
  • Moses Lake, WA
  • NPI 1386739308
  NPD (past)

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

{
    "created_epoch": "1354838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1134464738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S COOLIDGE ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371872",
            "telephone_number": "509-793-9715",
            "fax_number": "509-764-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 S PIONEER WAY",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988374613",
            "telephone_number": "509-793-9780",
            "fax_number": "509-764-3246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 E Wheeler Rd",
            "address_purpose": "LOCATION",
            "city": "Moses Lake",
            "state": "WA",
            "postal_code": "988371820",
            "country_code": "US",
            "telephone_number": "509-765-5606",
            "fax_number": "509-764-3244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYO",
        "first_name": "PENNY",
        "middle_name": "TALCOTT",
        "credential": "RN, CDCES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-07",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "WA",
            "license": "RN00165575",
            "primary": true
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "WA",
            "license": "RN00165575",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2040700",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmayo1203448@wm.providencedirect.org",
            "affiliation": "N",
            "endpointDescription": "EPIC EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1550 S Pioneer Way",
            "city": "Moses Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988374613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrea Matson, DO
• Craig Yukio Matsuda, R.PH
• Hollie L Matthews, MD
• Tiana Maua, BA
• Avery Maxfield, LMP
• Qi Ying McClelland, MD
• Dennis D McCoy
• Denise Andrea McDonald, REGISTERED NURSE
• Elizabeth McGraw, PA-C
• Ronald McHargue, DDS

• Diabetes Educator Registered Nurse in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Diabetes Educator Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.