Bonita E. Penn, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

LG-0001008 Issued in DE

Practice address

200 Biddle Ave Ste 100
Newark, DE 19702-3967

Phone

(302) 836-7820

Fax

(302) 836-7826

NPI assigned

Feb 14, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DE, WA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians

Christiana Care Quality PartnersGroup PAC ID 0143657247, 96 clinicians

Pacific County Hospital District 2Group PAC ID 8224939301, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willapa Harbor Hospital Hospital, South Bend, WA, CCN 501303

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bonita.penn.1@30646.direct.athenahealth.com
• Direct secure messaging: bonita.penn@ghuccc.eclinicaldirectplus.com

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.

• Christiana Care Quality Partners

  dba ChristianaCare GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Newark, DE
  • NPI 1164061867
  Medicare reassignment Care Compare group NPD
• Peacehealth Networks on Demand, LLC

  dba Zoom Management

  • General Practice Physician
  • Tigard, OR
  • NPI 1023582178

  WA

  Medicare reassignment Care Compare group NPD
• Pacific County Hospital District 2

  dba Willapa Harbor Hospital

  • Critical Access Hospital
  • South Bend, WA
  • NPI 1295708683
  Medicare reassignment Care Compare group
• Westside Family Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Wilmington, DE
  • NPI 1952303695
  Medicare reassignment NPD
• Westside Family Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Wilmington, DE
  • NPI 1669479929
  NPD
• Christiana Care Quality Partners

  dba ChristianaCare GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Wilmington, DE
  • NPI 1881367332
  NPD (past)

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

• Pacific County Hospital District 2

  dba Willapa Harbor Hospital

  • Critical Access Hospital
  • South Bend, WA
  • NPI 1295708683
  Care Compare affiliation

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1679012330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-6212",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BIDDLE AVE STE 100",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023967",
            "telephone_number": "302-836-7820",
            "fax_number": "302-836-7826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 N Clayton St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198053155",
            "country_code": "US",
            "telephone_number": "302-575-8040",
            "fax_number": "302-575-8005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENN",
        "first_name": "BONITA",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-14",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0001008",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0001008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bonitapenn@sffp.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "St. Francis Hospital direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "701 N Clayton St Ste 200",
            "city": "Wilmington",
            "state": "DE",
            "country_code": "US",
            "postal_code": "198053155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Susan Linda Peluso, PHP MD
• Cindy Pence
• Manogna Pendyala, MD
• Peninsula Endoscopy Center
• Emily Penman, M.D,
• Tiffany Crystal Penn, MSN, RN CRNP
• Mercedes Jade Pennebaker
• Mark Anthony Penta, PA-C
• Drew Pento, PA-C
• Karen E. Penzone, MD

• Nurse Practitioner in Newark, DE
• Providers in Newark, DE by specialty
• Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.