NPIMap

Individual provider Active NPI

Larry Penick, MD

  • Family Medicine Physician
  • East Bernard, TX
National Provider Identifier
1528037579
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G6752 Issued in TX
Practice address
703 Morris St.
East Bernard, TX 77435
Phone
(979) 335-4433
Fax
(979) 335-4837
NPI assigned
Mar 14, 2006
Last updated
Jun 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G6752 TX
Family Medicine Physician 207Q00000X G6752 TX Primary
Emergency Medicine Physician 207P00000X G6752 TX

Addresses

Primary practice location

703 Morris St.
East Bernard, TX 77435

Mailing address

703 Morris
East Bernard, TX 77435
Phone (979) 335-4433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040419001182 TX Practitioner - Family PracticePractitioner - General PracticePractitioner - Emergency Medicine 5395730212 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 1983
Medicare assignment
May accept Medicare assignment
Group practices
CahrmcGroup PAC ID 6608916879, 32 clinicians
Ess of Port Lavaca LLCGroup PAC ID 2769766005, 17 clinicians

Practice addresses (Care Compare)

1011 S Dill St
East Bernard, TX 77435-8781
Phone (979) 335-4433

815 N Virginia St
Port Lavaca, TX 77979-3025
Phone (361) 552-6713

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dewitt Medical District Family Medicine CurrentSince Oct 5, 2009 Accepting new patients
Dewitt Medical District CurrentSince Oct 5, 2009 Accepting new patients
Cahrmc CurrentSince Apr 12, 2014 Accepting new patients
Jackson County Hospital District Emergency Medicine CurrentSince Feb 4, 2011 Accepting new patients
Hospital Care Consultants of Corpus Christi Emergency Medicine CurrentSince May 11, 2024 Accepting new patients
Cahrmc CurrentSince Apr 12, 2014 Accepting new patients
Dewitt Medical District Emergency Medicine Current Accepting new patients
Jackson County Hospital District CurrentSince Feb 4, 2011 Accepting new patients
Ess of Port Lavaca LLC Emergency Medicine CurrentSince May 11, 2024 Accepting new patients
Cahrmc Past Accepting new patients
Richard H. Rolnick, MD, PA Past Accepting new patients
Memorial Rehabilitation Associates, P.a. Past Accepting new patients
Bellville Hospital District Emergency Medicine Past Accepting new patients
Bellville Medical Center Family Medicine PastSince Aug 6, 2019 Accepting new patients
Knox County Hospital District Past Accepting new patients

Locations

6130 Parkway Dr
Corpus Christi, TX 78414
Phone (361) 826-5785

2550 N Esplanade St
Cuero, TX 77954
Phone (361) 275-0532

600 S Austin Rd
Eagle Lake, TX 77434
Phone (979) 234-5571

610 S Austin Rd
Eagle Lake, TX 77434
Phone (979) 234-2551

1011 S Dill St
East Bernard, TX 77435
Phone (979) 335-4433

703 Morris St
East Bernard, TX 77435
Phone (979) 335-4433

1013 S Wells St
Edna, TX 77957
Phone (361) 782-5241

113 W Main St
Kenedy, TX 78119
Phone (830) 583-0612

815 N Virginia St
Port Lavaca, TX 77979
Phone (361) 552-0325

18600 Hardy Oak Blvd
San Antonio, TX 78258
Phone (210) 404-0800

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 7

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1528037579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 MORRIS",
            "city": "EAST BERNARD",
            "state": "TX",
            "postal_code": "77435",
            "telephone_number": "979-335-4433",
            "fax_number": "979-335-4837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MORRIS ST.",
            "city": "EAST BERNARD",
            "state": "TX",
            "postal_code": "77435",
            "telephone_number": "979-335-4433",
            "fax_number": "979-335-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENICK",
        "first_name": "LARRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "G6752",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G6752",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "G6752",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Bernard, TX

Sources for this page

Verify at the official NPI Registry.