Penny Ann West, APRN

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

APRN11020708 Issued in FL

Practice address

10676 Marvin Jones Blvd
Live Oak, FL 32064-8242

Phone

(386) 658-5582

NPI assigned

May 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Department of HealthGroup PAC ID 3072424282, shared by 68 NPIs, 126 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Concierge Home Care Home health agency, Lake City, FL, CCN 687144
• Centerwell Home Health Home health agency, Lake City, FL, CCN 107420
• Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Acv Community Services LLC

  • Rural Health Clinic/Center
  • Live Oak, FL
  • NPI 1174630693
  Medicare reassignment NPD
• Andrews Healthcare Consulting

  • Family Nurse Practitioner
  • Trenton, FL
  • NPI 1013529635
  Medicare reassignment NPD
• Florida Department of Health

  • Public Health or Welfare Agency
  • Live Oak, FL
  • NPI 1215973870
  Medicare reassignment NPD
• Florida Department of Health

  • Public Health or Welfare Agency
  • Mayo, FL
  • NPI 1386611085
  Medicare reassignment NPD
• Florida Department of Health

  • Public Health or Welfare Agency
  • Bronson, FL
  • NPI 1154395390
  NPD

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

• Centerwell Health Services (Certified), Inc.

  • Home Health Agency
  • Lake City, FL
  • NPI 1669406377
  Care Compare affiliation Name & address match
• Concierge Home Care of Lake City LLC

  • Home Health Agency
  • Lake City, FL
  • NPI 1639777345
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Boynton Beach, FL
  • NPI 1467507657
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Miami Lakes, FL
  • NPI 1528113792
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Melbourne, FL
  • NPI 1669548053
  Care Compare affiliation
• Vitas Healthcare Corporation of Florida

  • Community Based Hospice Care Agency
  • Tallahassee, FL
  • NPI 1972555464
  Care Compare affiliation

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720310400000",
    "number": "1467199513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14144 94TH TRL",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320606391",
            "telephone_number": "386-209-7728",
            "fax_number": "386-658-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10676 MARVIN JONES BLVD",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320648242",
            "telephone_number": "386-658-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "PENNY",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-18",
        "last_updated": "2024-07-07",
        "certification_date": "2024-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "FL",
            "license": "RN9357132",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11020708",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "APRN11020708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467199513",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE NUMBER",
            "identifier": "APRN11020708",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "loganandrews@live.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "103 SE 3rd St",
            "city": "Trenton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "326933247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lana Ward
• Elvin F Warren III
• Zahoor A. Waseem, MD
• Barrinesha Deshawn Washington, MBA
• Melissa Waybrant-Ennis, APRN, DNP, PMHNP-BC
• Demaycia Jemirea Wheeler
• Teri Lynn Wilhoite, LMT
• Kristin N Williams
• Melania J Willis, ARNP
• Aymee Wilson, ARNP

• Geriatric Medicine (Family Medicine) Physician in Live Oak, FL
• Providers in Live Oak, FL by specialty
• Geriatric Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2024; 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.