Timothy R Penniston, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP3433 Issued in AZ

Practice address

4951 S White Mountain Rd BLDG a
Show Low, AZ 85901-7827

Phone

(928) 532-3926

Fax

(928) 537-9634

NPI assigned

Jul 25, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Healthcare Medical AssociatesGroup PAC ID 8729205737, 74 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Summit Healthcare Regional Medical Center Hospital, Show Low, AZ, CCN 030062

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timothypenniston@shrmcshma.allscriptsdirect.net

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.

• Summit Healthcare Medical Associates

  • Family Medicine Physician
  • Show Low, AZ
  • NPI 1467878108
  Medicare reassignment Care Compare group NPD
• Mariposa Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Patagonia, AZ
  • NPI 1003837618
  NPD
• Mariposa Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Nogales, AZ
  • NPI 1417985474
  NPD
• Mariposa Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Nogales, AZ
  • NPI 1487537445
  NPD
• Summit Healthcare Association

  • Rural Acute Care Hospital
  • Show Low, AZ
  • NPI 1144209271
  NPD
• Summit Healthcare Medical Associates

  • Rural Health Clinic/Center
  • Eagar, AZ
  • NPI 1063166999
  NPD
• Summit Healthcare Medical Associates

  • Rural Health Clinic/Center
  • Snowflake, AZ
  • NPI 1265188866
  NPD
• Mariposa Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Rio Rico, AZ
  • NPI 1013213404
  NPD (past)
• Mariposa Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Tubac, AZ
  • NPI 1578922787
  NPD (past)
• Summit Healthcare Association

  • Oncology Clinic/Center
  • Show Low, AZ
  • NPI 1083736128
  NPD (past)
• Urgent Care of Wyoming Inc.

  • Nurse Practitioner
  • Gillette, WY
  • NPI 1609896455
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Summit Healthcare Association

  • Oncology Clinic/Center
  • Show Low, AZ
  • NPI 1083736128

  Hospital

  Care Compare affiliation
• Summit Healthcare Association

  • Rural Acute Care Hospital
  • Show Low, AZ
  • NPI 1144209271
  Care Compare affiliation
• Summit Healthcare Medical Associates

  • Rural Health Clinic/Center
  • Overgaard, AZ
  • NPI 1770700767

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1144243692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 S WHITE MOUNTAIN RD BLDG A",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017827",
            "telephone_number": "928-532-3926",
            "fax_number": "928-537-9634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 S WHITE MOUNTAIN RD BLDG A",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017827",
            "telephone_number": "928-532-3926",
            "fax_number": "928-537-9634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNISTON",
        "first_name": "TIMOTHY",
        "middle_name": "R",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP3433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "453927",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Ellis Paronto
• Sarah Elizabeth Parsons, RN
• Jeffrey Peacock
• Pediatrics in the Pines PC
• Lu Ann Penchuk, FNP
• Colvin Perry, P.T.A
• Verlynne Perry, M.S., CCC-SLP
• John Frederick Peters, DDS
• Ha Phi
• Phoenix Vamc

• Family Nurse Practitioner in Show Low, AZ
• Providers in Show Low, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; 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.