Active NPI
Lindsay Penna
- Physician Assistant
- Yuma, AZ
National Provider Identifier
1568815348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 7289
- Practice address
- 2851 S Avenue B Ste 2001
Yuma, AZ 85364-7763 - Phone
- (928) 336-2434
- NPI assigned
- Jul 18, 2016
- Last updated
- Apr 4, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 019817-1 | NY | |
| Physician Assistant | 363A00000X | 7289 | AZ | Primary |
Addresses
Primary practice location
2851 S Avenue B Ste 2001
Yuma, AZ 85364-7763
Mailing address
10211 S Universe Ave
Yuma, AZ 85367-2204
Phone (716) 982-7852
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019817-1 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554336000000",
"number": "1568815348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10211 S UNIVERSE AVE",
"city": "YUMA",
"state": "AZ",
"postal_code": "853672204",
"telephone_number": "716-982-7852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2851 S AVENUE B STE 2001",
"city": "YUMA",
"state": "AZ",
"postal_code": "853647763",
"telephone_number": "928-336-2434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNA",
"first_name": "LINDSAY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-18",
"last_updated": "2019-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "019817-1",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "7289",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yuma, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.