Active NPI
Skye Penny
- General Practice Physician
- Conway, SC
National Provider Identifier
1689425720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 92504
- Practice address
- 300 Singleton Ridge Rd
Conway, SC 29526-9142 - Phone
- (843) 347-8134
- NPI assigned
- Mar 28, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Physician | 208D00000X | 92504 | SC | Primary |
Addresses
Primary practice location
300 Singleton Ridge Rd
Conway, SC 29526-9142
Mailing address
300 Singleton Ridge Rd
Conway, SC 29526-9142
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260421000105 | SC | Order and Referring Only - Family Practice | 6305312943 |
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4055 Valley View LN
Suite 700
Dallas, TX 75244-4910
4055 Valley View LN
Suite 700
Dallas, TX 75244-5045
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 92504 | SC | MD | General Practice Physician |
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": "1779148800000",
"number": "1689425720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 SINGLETON RIDGE RD",
"city": "CONWAY",
"state": "SC",
"postal_code": "295269142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 SINGLETON RIDGE RD",
"city": "CONWAY",
"state": "SC",
"postal_code": "295269142",
"telephone_number": "843-347-8134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNY",
"first_name": "SKYE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-28",
"last_updated": "2026-05-19",
"certification_date": "2026-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "SC",
"license": "92504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; 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.