Individual provider Active NPI

Beverly Gail Pennington, FNP

  • Family Nurse Practitioner
  • Galveston, TX
National Provider Identifier
1558728014
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP129982 Issued in TX
Practice address
400 Harborside Dr Ste 100
Galveston, TX 77555-4208
Phone
(409) 772-3373
NPI assigned
Jan 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP129982 TX
Family Nurse Practitioner 363LF0000X AP129982 TX Primary

Addresses

Primary practice location

400 Harborside Dr Ste 100
Galveston, TX 77555-4208

Mailing address

PO Box 650859
Dept 710
Dallas, TX 75265
Phone (409) 772-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170814001115 TX Practitioner - Nurse Practitioner 9234400029 Reassigns benefits to 1 organization
I20211007002325 WA Practitioner - Nurse Practitioner 9234400029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

400 Harborside Dr
Suite 100
Galveston, TX 77555-0001
Phone (409) 772-3373

Hospital & facility affiliations

  • Accentcare Home Health of Texas Home health agency, Galveston, TX, CCN 679104
  • Care & Cure Home Health, Inc. Home health agency, Houston, TX, CCN 673130
  • University of Texas Medical Branch Galveston Hospital, Galveston, TX, CCN 450018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP129982TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carelon Medical Partners, PC Nurse Practitioner CurrentSince Sep 28, 2021 Accepting new patients
Utmb Faculty Group Practice CurrentSince Apr 17, 2023 Accepting new patients

Locations

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

333 Commerce St
Ste 700
Nashville, TN 37201
Phone (615) 627-2293

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

11335 NE 122nd Way
Ste 105
Kirkland, WA 98034
Phone (206) 899-5479

Interoperability endpoints

  • Direct secure messaging: bpennington34458@direct.utmb.edu

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1558728014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650859",
            "address_2": "DEPT 710",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75265",
            "telephone_number": "409-772-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HARBORSIDE DR STE 100",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775554208",
            "telephone_number": "409-772-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "BEVERLY",
        "middle_name": "GAIL",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP129982",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP129982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.