Mark A. Penn, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

15507 Issued in NV

Practice address

55 Arch St Ste 3a
Akron, OH 44304-1447

Phone

(330) 375-3584

Fax

(330) 375-6306

NPI assigned

Jan 3, 2007

Sex

Male

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Roseman Medical Research Institute, LLC

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1023479052
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1154488419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10530 DISCOVERY DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891353050",
            "telephone_number": "702-802-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 ARCH ST STE 3A",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041447",
            "telephone_number": "330-375-3584",
            "fax_number": "330-375-6306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "MARK",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "OH",
            "license": "35042202",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "15507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0396361",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Anthony Pena, M.D
• Seth Michael Pender
• Annette Penn, MASTER OF ARTS
• Leah Grace Penn
• Marc S Penn, MD
• C. Christine Penna, CRNA
• Vincent Penna
• Elizabeth Pennington, COTA/L
• Gary A. Pennington, MD
• Michael Lanier Pennington Jr.

• Family Medicine Physician in Akron, OH
• Providers in Akron, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.