Penny Xuan Dupre, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD.203001 Issued in LA

Practice address

10075 Grand Bay Wilmer Rd S
Grand Bay, AL 36541-5003

Phone

(251) 865-1852

NPI assigned

Jun 11, 2008

Sex

Female

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 4

Medicare fee-for-service enrollment

Enrolled in AL

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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.

• Franklin Primary Health Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Mobile, AL
  • NPI 1679532303

  Pediatrics

  Medicare reassignment NPD
• South Alabama Medical Clinic, LLC

  • Rural Health Clinic/Center
  • Grand Bay, AL
  • NPI 1811288038

  Pediatrics

  Medicare reassignment NPD
• Wilmer Medical Clinic, LLC

  • Rural Health Clinic/Center
  • Wilmer, AL
  • NPI 1649667577

  Pediatrics

  Medicare reassignment NPD
• Franklin Primary Health Center Inc

  dba Baldwin Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Foley, AL
  • NPI 1932416195

  Pediatrics

  NPD
• Franklin Primary Health Center, Inc

  dba Franklin Evergreen Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Evergreen, AL
  • NPI 1346733821
  NPD
• Pediatric Emergency Specialists, PC

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Memphis, TN
  • NPI 1760482434
  NPD (past)

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1417117664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10075 GRAND BAY WILMER RD S",
            "city": "GRAND BAY",
            "state": "AL",
            "postal_code": "365415003",
            "telephone_number": "251-865-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10075 GRAND BAY WILMER RD S",
            "city": "GRAND BAY",
            "state": "AL",
            "postal_code": "365415003",
            "telephone_number": "251-865-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUPRE",
        "first_name": "PENNY",
        "middle_name": "XUAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD.203001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189689",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189935",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1087581",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191317",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bio-Medical Applications of Alabama, Inc. (Fresenius Medical Care South Mobile)
• Shane Champion
• Quyen Pham Chuong, PHARM. D
• Gail L Cook
• Tina Crane, PMHNP-BC
• Vantrell Terrell Fox
• Grand Bay Convalescent Home Inc
• Grand Bay Medical Center, Inc.
• Greenway Health and Rehabilitation Center LLC
• Gregory L. Kennedy D.M.D PC (Grand Bay Dental)

• Pediatrics Physician in Grand Bay, AL
• Providers in Grand Bay, AL by specialty
• Pediatrics Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; 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.