Terry Lynn Penner, MS ANP-C ACNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP-1086 Issued in AZ

Practice address

3514 N Power Rd Ste 127
Mesa, AZ 85215-2911

Phone

(480) 571-8460

Fax

(480) 571-8461

NPI assigned

Dec 31, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

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  Medicare reassignment NPD
• Sleepwerx, LLC

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  • Mesa, AZ
  • NPI 1477012045

  Single Specialty

  NPD Authorized official
• Southwest Center for Neurological Surgeons PC

  • Specialist
  • Mesa, AZ
  • NPI 1891901088

  Single Specialty

  NPD (past)
• Valley ENT, PC

  • Otolaryngology Physician
  • Scottsdale, AZ
  • NPI 1508990185

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1135987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555113600000",
    "number": "1669450508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3514 N POWER RD STE 127",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852152911",
            "telephone_number": "480-571-8460",
            "fax_number": "480-571-8461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3514 N POWER RD STE 127",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852152911",
            "telephone_number": "480-571-8460",
            "fax_number": "480-571-8461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNER",
        "first_name": "TERRY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MS ANP-C  ACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-31",
        "last_updated": "2019-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP-1086",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "RN066900",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP-1086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "584947",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Merenthia Pena, RBT
• Noelia Pena, PA
• Rogelio Pena, RD
• Amanda Phuong Thao Pendelton
• Allison Michelle Pendgraft, SLPA
• Emily Padgett Pennington, MS OT/L
• Sabrina Pennyman, COTA/L
• Garrett Michael Penrod, CPT
• Brianne Penrose, RN
• Jennifer Penrose, PHARM.D., BCPS

• Adult Health Nurse Practitioner in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Adult Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.