Omar Penney, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95004134 Issued in CA

Practice address

14362 Ramona Blvd
Baldwin Park, CA 91706-3241

Phone

(626) 337-0676

NPI assigned

Jun 15, 2016

Sex

Male

Sole proprietor

Yes

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 CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1669822144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7091 STOCKTON DR",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928803989",
            "telephone_number": "626-589-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14362 RAMONA BLVD",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917063241",
            "telephone_number": "626-337-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNEY",
        "first_name": "OMAR",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-15",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95004134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandy Nicole Patricio
• Finster L. Paul II, MD
• Megan Pearson-Cody, M.D.
• Nora Pekarek
• Ma. Lilibeth K. Penafuerte, MS, RD
• Aglaia Perea
• Edwin Jude Peres Da Silva, MD
• Melissa Perez, MS
• Saira Perez, DA
• Annette Marie Perry, P.T.

• Family Nurse Practitioner in Baldwin Park, CA
• Providers in Baldwin Park, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; 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.