Active NPI
Vicki Allen Penwell, CPM
- Midwife
- Boise, ID
National Provider Identifier
1598091910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 83069-R
- Practice address
- 2829 N Citrus PL
Boise, ID 83713-5185 - Phone
- (208) 954-6788
- NPI assigned
- Oct 20, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 83069-R | NM | Primary |
Addresses
Primary practice location
2829 N Citrus PL
Boise, ID 83713-5185
Mailing address
PO Box 190563
Boise, ID 83719-0563
Phone (208) 954-6788
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83069-R | NM | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255996800000",
"number": "1598091910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 190563",
"city": "BOISE",
"state": "ID",
"postal_code": "837190563",
"telephone_number": "208-954-6788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2829 N CITRUS PL",
"city": "BOISE",
"state": "ID",
"postal_code": "837135185",
"telephone_number": "208-954-6788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENWELL",
"first_name": "VICKI",
"middle_name": "ALLEN",
"name_prefix": "Ms.",
"credential": "CPM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-20",
"last_updated": "2009-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "NM",
"license": "83069-R",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.