Individual provider Active NPI

Joshua B. Penrod, DO

  • Family Medicine Physician
  • Richland, WA
National Provider Identifier
1396301701
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61285676 Issued in WA
Practice address
560 Gage Blvd Ste 101&206
Richland, WA 99352-8650
Phone
(509) 942-3286
Fax
(509) 628-1354
NPI assigned
May 13, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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 OP61285676 WA Primary

Addresses

Primary practice location

560 Gage Blvd Ste 101&206
Richland, WA 99352-8650

Mailing address

550 Gage Blvd Ste 101
Richland, WA 99352-9532
Phone (509) 942-3627

Other practice location 1

11937 US Hwy 271
Attn: Kate Wells
Tyler, TX 75708
Phone (903) 877-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kate.wells@uthct.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20220822000729 WA Practitioner - Family Practice 7810221306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

560 Gage Blvd
Suite 101And206
Richland, WA 99352-8650
Phone (509) 942-3286

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP61285676WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center CurrentSince Aug 1, 2022 Accepting new patients
Kadlec Regional Medical Center CurrentSince Aug 1, 2022 Accepting new patients

Locations

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

550 Gage Blvd
Ste 101
Richland, WA 99352

560 Gage Blvd
Ste 101
Richland, WA 99352
Phone (509) 628-2843

560 Gage Blvd
Ste 101206
Richland, WA 99352
Phone (509) 942-3286

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

Interoperability endpoints

  • Direct secure messaging: jpenrod2415750@wm.providencedirect.org

Organizations & group practices 2

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 3

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": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1396301701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "509-942-3627",
            "fax_number": "509-627-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 GAGE BLVD STE 101&206",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993528650",
            "telephone_number": "509-942-3286",
            "fax_number": "509-628-1354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11937 US Hwy 271",
            "address_2": "Attn: Kate Wells",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "75708",
            "country_code": "US",
            "telephone_number": "903-877-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENROD",
        "first_name": "JOSHUA",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-13",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61285676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kate.wells@uthct.edu",
            "affiliation": "N",
            "endpointDescription": "Institutional Coordinator",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Coordinator",
            "address_1": "11937 US Hwy 271",
            "address_2": "Attn: Kate Wells",
            "city": "Tyler",
            "state": "TX",
            "country_code": "US",
            "postal_code": "75708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.