Individual provider Active NPI

Danielle M Penington, PA-C

  • Physician Assistant
  • Gardner, KS
National Provider Identifier
1255092672
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-02631 Issued in KS
Practice address
29475 W 189TH Ter
Gardner, KS 66030-9428
Phone
(913) 856-5577
Fax
(913) 956-3907
NPI assigned
Jan 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15-02631 KS Primary

Addresses

Primary practice location

29475 W 189TH Ter
Gardner, KS 66030-9428

Mailing address

29475 W 189TH Ter
Gardner, KS 66030-9428
Phone (913) 856-5577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220727003477 KS Practitioner - Physician Assistant 7113309824 Reassigns benefits to 1 organization
I20241126002972 NM Practitioner - Physician Assistant 7113309824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jayhawk Primary Care IncGroup PAC ID 8123928900, 157 clinicians
Duke City Urgent CareGroup PAC ID 3173848058, 35 clinicians

Practice addresses (Care Compare)

29475 W 189TH Ter
Gardner, KS 66030-9428
Phone (913) 588-1227

4410 Irving Blvd NW
Suite 300
Albuquerque, NM 87114-5951
Phone (505) 814-1995

7200 Montgomery Blvd NE
Albuquerque, NM 87109-1510
Phone (505) 207-3421

Hospital & facility affiliations

  • University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1255092672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29475 W 189TH TER",
            "city": "GARDNER",
            "state": "KS",
            "postal_code": "660309428",
            "telephone_number": "913-856-5577",
            "fax_number": "913-856-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29475 W 189TH TER",
            "city": "GARDNER",
            "state": "KS",
            "postal_code": "660309428",
            "telephone_number": "913-856-5577",
            "fax_number": "913-956-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENINGTON",
        "first_name": "DANIELLE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardner, KS

Sources for this page

Verify at the official NPI Registry.