William J Penn, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD00020401 Issued in WA

Practice address

201 Tahoma Blvd
Suite 102
Yelm, WA 98597-7735

Phone

(360) 458-7761

NPI assigned

May 26, 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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: william.penn@yfm.directbygreenway.com

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1194771535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 TAHOMA BLVD",
            "address_2": "SUITE 102",
            "city": "YELM",
            "state": "WA",
            "postal_code": "985977735",
            "telephone_number": "360-458-7761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 TAHOMA BLVD",
            "address_2": "SUITE 102",
            "city": "YELM",
            "state": "WA",
            "postal_code": "985977735",
            "telephone_number": "360-458-7761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00020401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I - WORKERS COMP",
            "identifier": "62141",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "T00079",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018621",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jathzeel Amadeo Olivares, DPT
• Sharon J Olson, ARNP
• Our Shared Roots
• Madison Carrie Ann Pate, LMT
• Frances L Pearre
• Stephanie Lyn Petersen, LMT
• Morgan Phillips, PT, DPT
• Kaela Pivnick, RD
• Austin Tyler Platt
• Pt2Excel PLLC

• Emergency Medicine Physician in Yelm, WA
• Providers in Yelm, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.