NPIMap

Individual provider Active NPI

Reggie Darnell Pennypacker, APRN-CNP

  • Family Nurse Practitioner
  • Duncan, OK
National Provider Identifier
1275960304
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
76980 Issued in OK
Practice address
3125 Brookwood Ave
Duncan, OK 73533-1362
Phone
(580) 786-4018
Fax
(580) 786-4021
NPI assigned
Oct 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 76980 OK
Family Nurse Practitioner 363LF0000X 76980 OK Primary

Addresses

Primary practice location

3125 Brookwood Ave
Duncan, OK 73533-1362

Mailing address

3125 Brookwood Ave
Duncan, OK 73533-1362
Phone (580) 786-4018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131126000956 OK Practitioner - Nurse Practitioner 6709822349 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reggie Pennypacker, Aprn-CNP, PLLCGroup PAC ID 2668708371, 4 clinicians

Practice addresses (Care Compare)

3125 Brookwood Ave
Duncan, OK 73533-1362
Phone (580) 786-4018

Hospital & facility affiliations

  • Health Watch Health Care of Duncan, LLC Home health agency, Duncan, OK, CCN 377296
  • A Path of Care Home Health VI, LLC Home health agency, Lawton, OK, CCN 377669
  • Duncan Regional Hospital Home Care Home health agency, Duncan, OK, CCN 377142
  • Elara Caring IV Home health agency, Chickasha, OK, CCN 377690
  • Centric Home Health Home health agency, Durant, OK, CCN 377791
  • Duncan Regional Hospital, Inc Hospital, Duncan, OK, CCN 370023
  • Jefferson County Hospital Hospital, Waurika, OK, CCN 371311
  • O U Medical Center Hospital, Oklahoma City, OK, CCN 370093
  • Memorial Health Hospital, Lawton, OK, CCN 370056

Merit-based Incentive Payment System (MIPS)

Final score
85.19 of 100Reported as individual
Quality
90.79
Improvement activities
40
Cost
62.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
76980OKMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Emergency Services PC CurrentSince Jan 1, 2017 Accepting new patients
Reggie Pennypacker, Aprn-CNP, PLLC CurrentSince Jul 9, 2019 Accepting new patients
Duncan Regional Hospital, Inc. Past Accepting new patients
Summit Medical Center Past Accepting new patients
Duncan Regional Hospital, Inc Past Accepting new patients

Locations

1611 N Brookwood Dr
Duncan, OK 73533
Phone (580) 786-4018

2434 Harville Rd
Ste 400
Duncan, OK 73533
Phone (580) 786-4018

9600 Broadway Ext
Oklahoma City, OK 73114
Phone (405) 486-2100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FCFHAD/Endpoint/FCFHAD
  • Direct secure messaging: reggie.pennypacker@pfnp.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pennypacker Family CareDuncan, OK, CCN 373913 Rural health clinic 5% Or Greater Direct Ownership Interest (51%) Jul 18, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1275960304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 BROOKWOOD AVE",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331362",
            "telephone_number": "580-786-4018",
            "fax_number": "580-786-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 BROOKWOOD AVE",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735331362",
            "telephone_number": "580-786-4018",
            "fax_number": "580-786-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNYPACKER",
        "first_name": "REGGIE",
        "middle_name": "DARNELL",
        "name_prefix": "Mr.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-03",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OK",
            "license": "76980",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "76980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncan, OK

Sources for this page

Verify at the official NPI Registry.