Individual provider Active NPI

Lydia Ann Pennington, APRN

  • Family Nurse Practitioner
  • Rush, KY
National Provider Identifier
1467190868
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3017667 Issued in KY
Practice address
7715 E US Highway 60
Rush, KY 41168-8807
Phone
(606) 547-1303
NPI assigned
May 25, 2022
Last updated
May 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3017667 KY Primary

Addresses

Primary practice location

7715 E US Highway 60
Rush, KY 41168-8807

Mailing address

7715 E US Highway 60
Rush, KY 41168-8807
Phone (606) 547-1303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220829000452 KY Practitioner - Nurse Practitioner 6204210008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.34 of 100Reported as group
Quality
96.98
Promoting interoperability
100
Improvement activities
40
Cost
74.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3017667KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis Family Care, Inc. Family CurrentSince Aug 8, 2022 Accepting new patients

Locations

6628 US Route 60
Ashland, KY 41102
Phone (606) 467-3222

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1467190868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7715 E US HIGHWAY 60",
            "city": "RUSH",
            "state": "KY",
            "postal_code": "411688807",
            "telephone_number": "606-547-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7715 E US HIGHWAY 60",
            "city": "RUSH",
            "state": "KY",
            "postal_code": "411688807",
            "telephone_number": "606-547-1303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "LYDIA",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3017667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rush, KY

Sources for this page

Verify at the official NPI Registry.