Cicely Evette Penn, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5015863 Issued in NC

Practice address

1251 Pinnacle Church Road
Nebo, NC 28761-5753

Phone

(336) 285-7915

NPI assigned

Apr 15, 2014

Last updated

Feb 7, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alamance Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Burlington, NC
  • NPI 1326010273
  Medicare reassignment NPD
• Best Day Psychiatry and Counseling, PC

  • Prescribing (Medical) Psychologist
  • Fayetteville, NC
  • NPI 1477506343

  Psychiatry

  Medicare reassignment NPD
• Holly Hill Hospital LLC

  dba Holly Hill Hospital

  • Psychiatric Hospital
  • Raleigh, NC
  • NPI 1518037233

  Psychiatry

  Medicare reassignment NPD
• The Moses H. Cone Memorial Hospital Operating Corporation

  dba Cone Health Sickle Cell Center

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1013265909
  Medicare reassignment NPD
• Alamance Regional Medical Center, Inc

  dba ARMC Health Care Employee Pharmacy

  • Pharmacy
  • Burlington, NC
  • NPI 1851681993
  NPD
• Best Day Psychiatry and Counseling, PC

  • Psychiatry Physician
  • Mount Pleasant, SC
  • NPI 1467291542
  NPD
• Best Day Psychiatry and Counseling, PC

  • Psychiatry Physician
  • Fuquay Varina, NC
  • NPI 1538537519
  NPD (past)

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1487073623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1149",
            "city": "NEBO",
            "state": "NC",
            "postal_code": "287610964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 PINNACLE CHURCH ROAD",
            "city": "NEBO",
            "state": "NC",
            "postal_code": "287615753",
            "telephone_number": "336-285-7915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "CICELY",
        "middle_name": "EVETTE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5015863",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "231098",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NC Outreach Group Homes, LLC
• Robert Newton
• Ruth Joy Newton, RN
• Melanie Markham Orange, M.D.
• Tamra Arlene Orders, RN
• Rebeca Perez-Gonzalez, LCSWA
• Erika V Perry, LPCA
• Kelly M. Prescott, M.S. CCC-SLP
• Katrina Anne Ramsey, COTA/L
• Catherine Mary Rankin, RN

• Psychiatric/Mental Health Nurse Practitioner in Nebo, NC
• Providers in Nebo, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.