Individual provider Active NPI

Penny L Houseman, NP-C

  • Family Nurse Practitioner
  • Cape Coral, FL
National Provider Identifier
1609279314
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11011390 Issued in FL
Practice address
227 SE 43Rd Ter
Cape Coral, FL 33904-8424
Phone
(239) 738-8311
Fax
(239) 778-9789
NPI assigned
Oct 8, 2014
Last updated
Mar 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71005194A IN
Family Nurse Practitioner 363LF0000X APRN11011390 FL Primary

Addresses

Primary practice location

227 SE 43Rd Ter
Cape Coral, FL 33904-8424

Mailing address

227 SE 43Rd Ter
Cape Coral, FL 33904-8424
Phone (239) 738-8311

Other identifiers 3

IdentifierTypeStateIssuer
0117645MedicaidOH
000000899250OtherINANTHEM
201258910MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220226000031 FL Practitioner - Nurse Practitioner 4486978947 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

Practice addresses (Care Compare)

1781 Four Mile Cove Pkwy
Unit 145
Cape Coral, FL 33990-2402

227 SE 43Rd Ter
Cape Coral, FL 33904-8424
Phone (239) 738-8311

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11011390FLMDFamily Nurse Practitioner
71005194AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South West Florida Complete Healthcare LLC CurrentSince Sep 1, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1609279314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 SE 43RD TER",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339048424",
            "telephone_number": "239-738-8311",
            "fax_number": "239-778-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 SE 43RD TER",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339048424",
            "telephone_number": "239-738-8311",
            "fax_number": "239-778-9789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSEMAN",
        "first_name": "PENNY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-08",
        "last_updated": "2024-03-27",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71005194A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11011390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0117645",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000899250",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201258910",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.