David J Penn, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

04-24443 Issued in KS

Practice address

211 E Main St
Carbondale, KS 66414-9607

Phone

(785) 836-7111

Fax

(785) 836-9251

NPI assigned

Jun 8, 2006

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dpenn6491@stormontvaildirect.org

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.

• Cotton-O'Neil Clinic Revocable Trust

  • Internal Medicine Physician
  • Topeka, KS
  • NPI 1811944457

  Family Medicine, KS

  Medicare reassignment NPD
• Cotton-O'Neil Clinic Revocable Trust

  • Durable Medical Equipment & Medical Supplies
  • Topeka, KS
  • NPI 1700076015
  NPD

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1295775922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E MAIN ST",
            "city": "CARBONDALE",
            "state": "KS",
            "postal_code": "664149607",
            "telephone_number": "785-836-7111",
            "fax_number": "785-836-9251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E MAIN ST",
            "city": "CARBONDALE",
            "state": "KS",
            "postal_code": "664149607",
            "telephone_number": "785-836-7111",
            "fax_number": "785-836-9251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-24443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "067059",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100159180B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jourdan Nikole Heitschmidt, APN
• Heather Lynn Kuder, P.T.A.
• Monte Keith Kuder, D.C.
• Medra LLC
• Osage County Chiropractic, P.a.
• Kelli Robinson, PTA
• Santa Fe Trail Usd 434
• Stormont-Vail Healthcare Inc
• Sweet Country Homes, Inc.
• Jenna D Weekley, APRN

• All providers in Carbondale, KS
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; 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.