Penny L Champion, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

R079412 Issued in GA

Practice address

414 5TH Ave
Albany, GA 31701-1976

Phone

(229) 883-4555

Fax

(229) 888-0063

NPI assigned

Aug 30, 2005

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

Other identifiers 1

Other names 1

• Penny L Bozeman Former name

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

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.

• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment NPD
• Women'S Health Professionals LLC

  • Specialist
  • Albany, GA
  • NPI 1588786495
  NPD

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481241600000",
    "number": "1265425797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 FIFTH AVENUE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "31701",
            "telephone_number": "229-883-4555",
            "fax_number": "229-888-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 5TH AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011976",
            "telephone_number": "229-883-4555",
            "fax_number": "229-888-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPION",
        "first_name": "PENNY",
        "middle_name": "L",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2016-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "R079412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00787146A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENNY",
            "last_name": "BOZEMAN",
            "middle_name": "L",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Central Albany OB-GYN, P.C.
• Centre' for Cosmetic Dentistry
• Diane Kathleen Cerjan, PSYD
• Timothy Barrett Chaffin, FNP
• Kristen H Champion, NP
• William E Chandler, MD
• Cynthia Ann Chaney, NP
• Charms Personal Care Home,Inc
• Daniel Brooks Chastain, PHARM.D.
• Sandra P Cheevers, M.D.

• Advanced Practice Midwife in Albany, GA
• Providers in Albany, GA by specialty
• Advanced Practice Midwife in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.