Active NPI
Annalyn Penkala, DO
- Family Medicine Physician
- Tupelo, MS
National Provider Identifier
1528754900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34926
- Practice address
- 1665 S Green St
Tupelo, MS 38804-6556 - Phone
- (662) 377-2261
- NPI assigned
- Apr 18, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34926 | MS | Primary |
Addresses
Primary practice location
1665 S Green St
Tupelo, MS 38804-6556
Mailing address
271 Fonderlac Dr SE
Warren, OH 44484-2158
Phone (330) 979-9632
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230801000152 | MS | Order and Referring Only - Family Practice | 0547621047 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- West Virginia School of Osteopathic Medicine, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
118 Long Leaf Dr
Medina, TN 38355-1202
PO Box
Suite 7058
Tupelo, MS 38802
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Mississippi Medical Center | Current | Accepting new patients |
Locations
830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136
Interoperability endpoints
- annalynpenkala@nmhs.medalliesdirect.net
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Tupelo, MS
- NPI 1376969683
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tupelo, MS
- NPI 1598875460
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784592000000",
"number": "1528754900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "271 FONDERLAC DR SE",
"city": "WARREN",
"state": "OH",
"postal_code": "444842158",
"telephone_number": "330-979-9632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1665 S GREEN ST",
"city": "TUPELO",
"state": "MS",
"postal_code": "388046556",
"telephone_number": "662-377-2261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENKALA",
"first_name": "ANNALYN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-18",
"last_updated": "2026-07-21",
"certification_date": "2026-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "34926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tupelo, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.