Active NPI
Holly Penix, NP
- Adult Health Nurse Practitioner
- Mansfield, OH
National Provider Identifier
1548812159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- APRN.CNP.024854
- Practice address
- 1025 S Trimble Rd
Mansfield, OH 44906-3427 - Phone
- (419) 529-4602
- NPI assigned
- Jul 13, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | APRN.CNP.024854 | OH | |
| Adult Health Nurse Practitioner | 363LA2200X | APRN.CNP.024854 | OH | Primary |
Addresses
Primary practice location
1025 S Trimble Rd
Mansfield, OH 44906-3427
Mailing address
1025 S Trimble Rd
Mansfield, OH 44906-3427
Phone (419) 529-4602
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- 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 |
|---|---|---|---|---|
| I20220719002995 | OH | Order and Referring Only - General Practice | 1850772047 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642809600000",
"number": "1548812159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 S TRIMBLE RD",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449063427",
"telephone_number": "419-529-4602"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 S TRIMBLE RD",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449063427",
"telephone_number": "419-529-4602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENIX",
"first_name": "HOLLY",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-13",
"last_updated": "2022-01-22",
"certification_date": "2022-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "OH",
"license": "APRN.CNP.024854",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "OH",
"license": "APRN.CNP.024854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2022; 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.