Individual provider Active NPI

Christopher Paul Penning, D.O.

  • Family Medicine Physician
  • Bridge City, TX
National Provider Identifier
1679555734
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J4428 Issued in TX
Practice address
615 W Round Bunch Rd
Bridge City, TX 77611-2434
Phone
(409) 735-7305
Fax
(409) 792-0201
NPI assigned
Nov 15, 2005
Last updated
Mar 18, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J4428 TX Primary

Addresses

Primary practice location

615 W Round Bunch Rd
Bridge City, TX 77611-2434

Mailing address

615 W Round Bunch Rd
Bridge City, TX 77611-2434
Phone (409) 735-7305

Other identifiers 1

IdentifierTypeStateIssuer
159305501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120404001003 TX Practitioner - Family Practice 9830263284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Golden Triangle Family Care CenterGroup PAC ID 7113970203, 2 clinicians

Practice addresses (Care Compare)

615 W Round Bunch Rd
Bridge City, TX 77611-2434
Phone 409735730530

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
94.26
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
J4428TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
C H Wilkinson Physician Network Family Medicine PastSince Jul 1, 2003 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1679555734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W ROUND BUNCH RD",
            "city": "BRIDGE CITY",
            "state": "TX",
            "postal_code": "776112434",
            "telephone_number": "409-735-7305",
            "fax_number": "409-792-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W ROUND BUNCH RD",
            "city": "BRIDGE CITY",
            "state": "TX",
            "postal_code": "776112434",
            "telephone_number": "409-735-7305",
            "fax_number": "409-792-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNING",
        "first_name": "CHRISTOPHER",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J4428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159305501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridge City, TX

Sources for this page

Verify at the official NPI Registry.