Individual provider Active NPI

Babette Pennay, CRNP

  • Primary Care Nurse Practitioner
  • Rockville, MD
National Provider Identifier
1609889112
Registry record updated May 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
R096053 Issued in MD
Practice address
15245 Shady Grove Rd
Suite 130
Rockville, MD 20850-3222
Phone
(301) 527-1650
Fax
(301) 527-8752
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X R096053 MD Primary

Addresses

Primary practice location

15245 Shady Grove Rd
Suite 130
Rockville, MD 20850-3222

Mailing address

P.O. Box 10067
Gaithersburg, MD 20898-9998
Phone (301) 527-1650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20070322000472 DC Practitioner - Nurse Practitioner 8123122660 Reassigns benefits to 1 organization
I20160422001815 MD Practitioner - Nurse Practitioner 8123122660 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians
Tidalhealth Atlantic IncGroup PAC ID 2365437837, 95 clinicians

Practice addresses (Care Compare)

100 E Carroll St
Salisbury, MD 21801-5422

10231 Old Ocean City Blvd
Suite 104
Berlin, MD 21811-3567
Phone (410) 629-6863

9733 Healthway Dr
Berlin, MD 21811-1155
Phone (410) 912-4976

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R096053MDMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ravi Passi MD PC CurrentSince Jul 16, 2009 Accepting new patients
Tidalhealth Atlantic, Inc. CurrentSince Apr 5, 2017 Accepting new patients
Atlantic General Hospital Corporation Current Accepting new patients
Tidalhealth Specialty Care, LLC CurrentSince Mar 1, 2026 Accepting new patients
Atlantic General Hospital Corp CurrentSince Apr 5, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

10231 Old Ocean City Blvd
Ste 104
Berlin, MD 21811
Phone (410) 629-6863

9714 Healthway Dr
Berlin, MD 21811
Phone (410) 641-2600

10026 Old Ocean City Blvd
Ste 1
Berlin, MD 21811

848 S Rolling Rd
Catonsville, MD 21228
Phone (301) 527-1650

15245 Shady Grove Rd
Ste 130
Rockville, MD 20850
Phone (301) 527-1650

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

6040 Public Landing Rd
Snow Hill, MD 21863
Phone (410) 629-0041

Organizations & group practices 6

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305244800000",
    "number": "1609889112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 10067",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208989998",
            "telephone_number": "301-527-1650",
            "fax_number": "301-527-8752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15245 SHADY GROVE RD",
            "address_2": "SUITE 130",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503222",
            "telephone_number": "301-527-1650",
            "fax_number": "301-527-8752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNAY",
        "first_name": "BABETTE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2011-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R096053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.