Courtney Brooke Penn, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024182616 Issued in VA

Practice address

11835 Fishing Point Dr Ste 104
Newport News, VA 23606-2584

Phone

(757) 599-5588

NPI assigned

Sep 7, 2021

Sex

Female

Sole proprietor

Yes

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

Enrolled in VA

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 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
• Riverside Smithfield Hospital Hospital, Smithfield, VA, CCN 490149
• Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cpenn133845@direct.rivhs.com

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.

• Riverside Physician Services Inc

  • Gastroenterology Physician
  • Newport News, VA
  • NPI 1194929026
  Medicare reassignment Care Compare group NPD
• Riverside Physician Services Inc

  • Gastroenterology Physician
  • Williamsburg, VA
  • NPI 1083867311
  NPD
• Riverside Physician Services, Inc.

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1710020623
  NPD
• Riverside Physician Services Inc

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1013933977
  NPD (past)

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

• Riverside Hospital Inc

  • General Acute Care Hospital
  • Smithfield, VA
  • NPI 1366259863
  Care Compare affiliation
• Riverside Hospital Inc

  • General Acute Care Hospital
  • Newport News, VA
  • NPI 1366547747
  Care Compare affiliation
• Sentara Hospitals

  • General Acute Care Hospital
  • Hampton, VA
  • NPI 1336109107
  Care Compare affiliation

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1275202095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5508",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234710508",
            "telephone_number": "757-340-3489",
            "fax_number": "757-340-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 FISHING POINT DR STE 104",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062584",
            "telephone_number": "757-599-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "COURTNEY",
        "middle_name": "BROOKE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024182616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peninsula Pulmonary Associates PC
• Peninsula Radiological Associates Limited
• Peninsula Surgery Center LLC
• Peninsula Therapy Center, PLC
• Peninsula Williamsburg Cardiology Assoc
• Patrice Pennyfeather, NP
• Penuel LLC
• Pastien Peou, MS, PA-C
• Dawn Pereira
• Maria Perez Sierra, CNM

• Family Nurse Practitioner in Newport News, VA
• Providers in Newport News, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.