Individual provider Active NPI

Brent Douglas Penhall, DO

  • Family Medicine Physician
  • Mooresville, NC
National Provider Identifier
1346431806
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2009-01914 Issued in NC
Practice address
106 Langtree Village Dr Ste 200
Mooresville, NC 28117
Phone
(704) 384-7101
Fax
(704) 384-7102
NPI assigned
Aug 8, 2007
Last updated
Apr 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2009-01914 NC Primary

Addresses

Primary practice location

106 Langtree Village Dr Ste 200
Mooresville, NC 28117

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

4315 Physicians Blvd
Suite 101
Harrisburg, NC 28075-7430
Phone (704) 455-6521

Other practice location 2

4315 Physicians Blvd
Suite 101
Harrisburg, NC 28075-7430
Phone (704) 455-6521

Other practice location 3

5641 Poplar Tent Rd
Suite 101
Concord, NC 28027-7533
Phone (704) 782-1955

Other practice location 4

8560 Cook St
MT Pleasant, NC 28124-7686
Phone (704) 436-6521

Other practice location 5

270 Copperfield Blvd NE
Suite 102
Concord, NC 28025-2441
Phone (704) 786-6521

Other practice location 6

123 Professional Park Dr
Locust, NC 28097-7712
Phone (704) 403-6760

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bpenhall746505@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20100823000776 NC Practitioner - Family Practice 8921132200 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

106 Langtree Village Dr
Suite 200
Mooresville, NC 28117-7571
Phone (704) 384-7101

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-5416

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2009-01914NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Feb 24, 2020 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 1, 2019 Accepting new patients
NH Digital Health Services, LLC CurrentSince Sep 1, 2020 Accepting new patients
NH Digital Health Services, LLC Family Medicine CurrentSince Sep 1, 2020 Accepting new patients
Novant Medical Group, Inc. Family Medicine CurrentSince Aug 1, 2019 Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

10816 Black Dog Ln
Ste 160
Charlotte, NC 28214
Phone (704) 316-3970

1901 Randolph Rd
Charlotte, NC 28207
Phone (704) 316-2000

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

3545 Whitehall Park Dr
Ste 300
Charlotte, NC 28273
Phone (704) 316-6187

8201 Healthcare Loop
Ste 305
Charlotte, NC 28215
Phone (980) 302-3050

19485 Old Jetton Rd
Ste 100
Cornelius, NC 28031
Phone (704) 316-5170

19830 Zion Ave
Cornelius, NC 28031
Phone (704) 384-1782

10030 Gilead Rd
Huntersville, NC 28078
Phone (704) 316-4000

14330 Oakhill Park Ln
Ste 200B
Huntersville, NC 28078
Phone 7043161265 ext. 6856

16525 Holly Crest Ln
Ste 150
Huntersville, NC 28078
Phone (704) 384-1725

6909 Prosperity Church Rd
Huntersville, NC 28078
Phone (704) 316-1830

1500 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 384-6500

106 Langtree Village Dr
Ste 200
Mooresville, NC 28117
Phone (704) 316-5570

130 Plantation Ridge Dr
Ste 100
Mooresville, NC 28117
Phone (704) 316-1635

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2085 Frontis Plaza Blvd
Winston Salem, NC 27103
Phone (336) 277-7226

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Interoperability endpoints

  • Direct secure messaging: bpenhall746505@direct.novanthealth.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1346431806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 LANGTREE VILLAGE DR STE 200",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117",
            "telephone_number": "704-384-7101",
            "fax_number": "704-384-7102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4315 Physicians Blvd",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "NC",
            "postal_code": "280757430",
            "country_code": "US",
            "telephone_number": "704-455-6521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4315 Physicians Blvd",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "NC",
            "postal_code": "280757430",
            "country_code": "US",
            "telephone_number": "704-455-6521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5641 Poplar Tent Rd",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280277533",
            "country_code": "US",
            "telephone_number": "704-782-1955",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8560 Cook St",
            "address_purpose": "LOCATION",
            "city": "MT Pleasant",
            "state": "NC",
            "postal_code": "281247686",
            "country_code": "US",
            "telephone_number": "704-436-6521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "270 Copperfield Blvd NE",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252441",
            "country_code": "US",
            "telephone_number": "704-786-6521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "123 Professional Park Dr",
            "address_purpose": "LOCATION",
            "city": "Locust",
            "state": "NC",
            "postal_code": "280977712",
            "country_code": "US",
            "telephone_number": "704-403-6760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENHALL",
        "first_name": "BRENT",
        "middle_name": "DOUGLAS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2009-01914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bpenhall746505@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "4315 Physicians Blvd",
            "address_2": "Suite 101",
            "city": "Harrisburg",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280757430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.