Penny Levill
Individual provider Active NPI Acute Care Nurse Practitioner · Manitou, KY
NPI 1649705708 · NPPES record last updated Apr 26, 2017
Key facts
- NPI
- 1649705708
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- 3011279 (KY)
- Practice address
- 465 Roscoe Veazey Rd
Manitou, KY 42436-9748 - Phone
- (270) 875-5819
- NPI assigned
- Apr 26, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of South Alabama College of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Baptist Health Deaconess Medical Group Inc
Practice addresses (Care Compare)
900 Hospital Dr
Madisonville, KY 42431-1644
Phone (270) 825-5800
Hospital & facility affiliations
- Baptist Health Deaconess Madisonville
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170612001800 | KY | Practitioner - Nurse Practitioner | 6204104490 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3011279 | KY | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Health Deaconess Medical Group Inc | Acute Care | Current |
Accepting new patients |
| Baptist Health Deaconess Medical Group Inc | Current |
Accepting new patients | |
| Southeastern Physician Services PC | Current |
Accepting new patients | |
| Baptist Health Deaconess Medical Group Inc | Current | Accepting new patients | |
| Baptist Health Deaconess Madisonville Inc | Past | Accepting new patients |
Locations
310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612
800 Hospital Dr
Fl 2
Madisonville, KY 42431
Phone (270) 326-3900
900 Hospital Dr
Madisonville, KY 42431
Phone (270) 326-3900
360 Amsden Ave
Versailles, KY 40383
Phone (606) 873-3111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 3011279 | KY | Yes |
Addresses
Primary practice location
465 Roscoe Veazey Rd
Manitou, KY 42436-9748
Mailing address
465 Roscoe Veazey Rd
Manitou, KY 42436-9748
Phone (270) 875-5819
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3011279 | Other | KY | APRN STATE LICENSE |
Other providers in Manitou, KY
All providers in Manitou, KY · Acute Care Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.