Annisa Suzette Penfold, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA26785 Issued in FL

Practice address

5006 Copper Ave NE
Albuquerque, NM 87108-1301

Phone

(505) 268-7988

NPI assigned

Jan 24, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Amistad Family Services Inc

  • Community/Behavioral Health Agency
  • Las Cruces, NM
  • NPI 1558654483
  NPD (past)
• Explorabilities Inc

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Albuquerque, NM
  • NPI 1346210473
  NPD (past)

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1255878641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9468 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328174150",
            "telephone_number": "407-281-3803",
            "fax_number": "407-249-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5006 COPPER AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081301",
            "telephone_number": "505-268-7988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENFOLD",
        "first_name": "ANNISA",
        "middle_name": "SUZETTE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-24",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA26785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martina Penalosa, MD, MPH
• Luis David Penaloza Vargas
• Stephanie Hue Pendergrass, MD
• Michael Pendleton, D.C., D.A.C.N.B
• Tiffany Ann Pendleton, D.O.
• Vicky Peng, MD
• Jessica Penick, MS, CCC-SLP
• Rebecca Penn
• Sandra F Penn, MD
• Sarah Penn, LPCC

• Physical Therapy Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physical Therapy Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.