Thomas Peter Penner, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD24585 Issued in OR

Practice address

1600 Delta Waters Rd
Suite 107
Medford, OR 97504-9114

Phone

(541) 858-2515

Fax

(541) 858-2514

NPI assigned

Jan 19, 2007

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 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Family Practice

Education

Loma Linda University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Immediate Care, LLCGroup PAC ID 7618876723, 36 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Valley Immediate Care, LLC

  • Urgent Care Clinic/Center
  • Medford, OR
  • NPI 1982709226

  Family Medicine, OR

  Medicare reassignment Care Compare group NPD
• Valley Immediate Care, LLC

  • Non-Pharmacy Dispensing Site
  • Ashland, OR
  • NPI 1275049546
  NPD (past)
• Valley Immediate Care, LLC

  • Non-Pharmacy Dispensing Site
  • Grants Pass, OR
  • NPI 1821504192
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1376696732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 N CENTRAL AVE",
            "address_2": "SUITE C",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975015873",
            "telephone_number": "541-734-9030",
            "fax_number": "541-734-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 DELTA WATERS RD",
            "address_2": "SUITE 107",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049114",
            "telephone_number": "541-858-2515",
            "fax_number": "541-858-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNER",
        "first_name": "THOMAS",
        "middle_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD24585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "MD24585",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Giovanna Peitz, MS, NCC, LPC
• Rebecca Pelican
• Eric A Pena, MD FACC
• David Neal Pence, QMHA
• Lorrin Penner
• Katie Dawn Pennington
• People'S Art Creative Arts Therapies, LLC
• Theresa Marie Peplinski, FNP
• Austin Joseph Percy, PHARMD
• Itzel Andrea Perez Zaragoza

• All providers in Medford, OR
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.