Teadra Pennycooke, CRNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

SP019459 Issued in PA

Practice address

1 Longsdorf Way
Carlisle, PA 17015-7623

Phone

(203) 918-4796

NPI assigned

Oct 22, 2018

Last updated

Nov 29, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Johns Hopkins Community Physicians, IncGroup PAC ID 8325943707, shared by 7 NPIs, 764 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medstar Health Home Care Home health agency, Hyattsville, MD, CCN 217150

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tpennycooke1047833@direct.hopkinsmedicine.org

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.

• Johns Hopkins Community Physicians, Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1578598868
  Medicare reassignment NPD
• Johns Hopkins Community Physicians, Inc

  dba JHCP - 195 Thomas Johnson Drive

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1770518003
  Medicare reassignment NPD
• Johns Hopkins Community Physicians

  dba JHCP- 6225 Smith Avenue; Mental Health Therapy

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1356161806
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Ihms Healthcare Incorporated

  • Geriatric Medicine (Family Medicine) Physician
  • Cordova, TN
  • NPI 1033978291
  NPD (past)
• Johns Hopkins Community Physicians, Inc

  dba JHCP - 5010 Regency PL Ste 300 - Provider Type: 20 - Physician

  • Internal Medicine Physician
  • White Plains, MD
  • NPI 1386590933
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Medstar Health Visiting Nurse Association, Inc.

  dba MedStar Health Home Care

  • Home Health Agency
  • Greenbelt, MD
  • NPI 1154437879
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1649746249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LONGSDORF WAY",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170157623",
            "telephone_number": "717-323-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LONGSDORF WAY",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170157623",
            "telephone_number": "203-918-4796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNYCOOKE",
        "first_name": "TEADRA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP019459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penn State Health Medical Group, LLC
• Penns Wood Physical Therapy Lim
• Penns Wood Physical Therapy Limited Partnership
• Pennsylvania CVS Pharmacy LLC (CVS Pharmacy #17185)
• Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #01646)
• Anna Pepler
• Allyn G. Perkins, D.M.D.
• Vladislav Petcov, OD
• Bethany Peters
• Lori Peters, LPC

• Primary Care Nurse Practitioner in Carlisle, PA
• Providers in Carlisle, PA by specialty
• Primary Care Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.