Individual provider Active NPI

Robert Lance Pennington, CRNA

  • Certified Registered Nurse Anesthetist
  • Gulf Breeze, FL
National Provider Identifier
1568464089
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9210408 Issued in FL
Practice address
4 Ocean View Dr
Gulf Breeze, FL 32561-2436
Phone
(850) 934-8157
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP9210408 FL Primary

Addresses

Primary practice location

4 Ocean View Dr
Gulf Breeze, FL 32561-2436

Mailing address

4 Ocean View Dr
Gulf Breeze, FL 32561-8965
Phone (850) 477-7042

Other identifiers 5

IdentifierTypeStateIssuer
P00164745OtherFLRAILROAD MEDICARE
306094200MedicaidFL
009945425MedicaidAL
59168859OtherALBLUE CROSS & BLUE SHIELD
G3419OtherFLBLUE CROSS & BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040524000235 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709877137 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams of Gulf Breeze LLCGroup PAC ID 9537326665, 38 clinicians
Ams National LLCGroup PAC ID 3870813025, 310 clinicians

Practice addresses (Care Compare)

1110 Gulf Breeze Pkwy
Gulf Breeze, FL 32561-4884
Phone (850) 934-2000

1890 Summit Blvd
Pensacola, FL 32503-3357
Phone (850) 549-9060

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Associates of Pensacola PA CurrentSince Nov 1, 2017 Accepting new patients
Florida Gulf Coast Anesthesia, LLC CurrentSince Dec 1, 2020 Accepting new patients
Gastroenterology Associates of Pensacola PA CurrentSince Nov 1, 2017 Accepting new patients
Ams Baptist LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 15, 2010 Accepting new patients
Ams of Gulf Breeze LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2012 Accepting new patients
Premier Anesthesia of Montgomery PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Hanover Anesthesia Group,Inc Past Accepting new patients
Anesthesia Health Care Partners of Florida Inc Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

4828 N Davis Hwy
Pensacola, FL 32503

511 Hewitt St
Pensacola, FL 32503
Phone (850) 912-6505

4810 N Davis Hwy
Pensacola, FL 32503
Phone (850) 474-8988

4724 N Davis Hwy
Pensacola, FL 32503
Phone (850) 444-4716

9400 University Pkwy
Pensacola, FL 32514
Phone (850) 208-6000

1000 W Moreno St
Pensacola, FL 32501
Phone (850) 434-4011

1110 Gulf Breeze Pkwy
Pensacola Beach, FL 32561
Phone (850) 438-1848

Organizations & group practices 9

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 1

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568464089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 OCEAN VIEW DR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325618965",
            "telephone_number": "850-477-7042",
            "fax_number": "850-474-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 OCEAN VIEW DR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325612436",
            "telephone_number": "850-934-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "ROBERT",
        "middle_name": "LANCE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9210408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00164745",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306094200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009945425",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "59168859",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "G3419",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.