Active NPI
Kimberly Penn
- Phlebotomy Technician
- Winston Salem, NC
National Provider Identifier
1669223509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- Practice address
- 450 W Hanes Mill Rd Ste 232
Winston Salem, NC 27105-7405 - Phone
- (336) 405-8674
- NPI assigned
- Mar 28, 2024
- Last updated
- Mar 28, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | NU | Primary |
Addresses
Primary practice location
450 W Hanes Mill Rd Ste 232
Winston Salem, NC 27105-7405
Mailing address
450 W Hanes Mill Rd Ste 232
Winston Salem, NC 27105-7405
Phone (336) 405-8674
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711584000000",
"number": "1669223509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 W HANES MILL RD STE 232",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271057405",
"telephone_number": "336-405-8674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 W HANES MILL RD STE 232",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271057405",
"telephone_number": "336-405-8674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENN",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-28",
"last_updated": "2024-03-28",
"certification_date": "2024-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.