Individual provider Active NPI

Melissa Kay Penn, LCSW

  • Clinical Social Worker
  • Quincy, IL
National Provider Identifier
1255439105
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
4409 Maine St
Quincy, IL 62305-5849
Phone
(217) 223-0423
Fax
(217) 223-0461
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X IL Primary

Addresses

Primary practice location

4409 Maine St
Quincy, IL 62305-5849

Mailing address

1309 Carrington CT
Quincy, IL 62305-7702
Phone (217) 223-0413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060317000048 IL Practitioner - Clinical Social Worker 1153338009 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Practice addresses (Care Compare)

927 Broadway St
Quincy, IL 62301-2719
Phone (217) 224-6423

Hospital & facility affiliations

  • Blessing Hospital Hospital, Quincy, IL, CCN 140015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149010208ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Blessingcare Corporation CurrentSince Jun 15, 2018 Accepting new patients
Quincy Clinical Laboratory Services SC Current Accepting new patients
West Central Pathology Specialists, S.C. Current Accepting new patients
Blessingcare Corporation CurrentSince Jun 15, 2018 Accepting new patients
Blessing Hospital CurrentSince Jun 1, 2022 Accepting new patients
Blessing Hospital CurrentSince Jun 1, 2022 Accepting new patients
Blessingcare Corporation CurrentSince Dec 13, 2018 Accepting new patients

Locations

640 W Washington St
Pittsfield, IL 62363
Phone (217) 285-2113

927 Broadway St
Ste 121
Quincy, IL 62301

1005 Broadway St
Quincy, IL 62301

1102 N County Road 700
Warsaw, IL 62379
Phone (217) 256-3800

Interoperability endpoints

  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod

Organizations & group practices 7

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255439105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 CARRINGTON CT",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623057702",
            "telephone_number": "217-223-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4409 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623055849",
            "telephone_number": "217-223-0423",
            "fax_number": "217-223-0461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "MELISSA",
        "middle_name": "KAY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.