Individual provider Active NPI

Judith Marie Penner, LMSW

  • Social Worker
  • Wichita, KS
National Provider Identifier
1194905224
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6917 Issued in KS
Practice address
8801 W 11TH St N
Wichita, KS 67212-4024
Phone
(316) 390-6547
NPI assigned
Nov 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6917 KS Primary

Addresses

Primary practice location

8801 W 11TH St N
Wichita, KS 67212-4024

Mailing address

8801 W 11TH St N
Wichita, KS 67212-4024
Phone (316) 390-6547

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6917KSMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1194905224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8801 W 11TH ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672124024",
            "telephone_number": "316-390-6547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8801 W 11TH ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672124024",
            "telephone_number": "316-390-6547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNER",
        "first_name": "JUDITH",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-06",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "6917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; 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.