Individual provider Active NPI

Marcy Marie Penrod, MSN, AGPC-NP

  • Gerontology Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1699318592
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
71009503A Issued in IN
Practice address
8333 Naab Rd
Indianapolis, IN 46260-5924
Phone
(317) 338-6666
NPI assigned
Oct 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 71009503A IN Primary

Addresses

Primary practice location

8333 Naab Rd
Indianapolis, IN 46260-5924

Mailing address

8333 Naab Rd
Indianapolis, IN 46260-5924
Phone (317) 338-6666

Other practice location 1

10694 Coyote Run
Fishers, IN 46038-8314
Phone (765) 251-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20210219000151 NC Practitioner - Nurse Practitioner 7113359795 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCPC-5 LLCGroup PAC ID 4284881012, 31 clinicians
MCPC-18, LLCGroup PAC ID 2668741208, 31 clinicians

Practice addresses (Care Compare)

155 Memorial Dr
Pinehurst, NC 28374-8710
Phone (910) 715-7650

205 Page Rd
Pinehurst, NC 28374-8749
Phone (910) 295-9211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.95 of 100Reported as group
Quality
65.05
Promoting interoperability
78
Improvement activities
40
Cost
87.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71009503AINMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MCPC-18, LLC CurrentSince Mar 1, 2021 Accepting new patients
MCPC-5, LLC CurrentSince Mar 1, 2021 Accepting new patients
MCPC-5, LLC Current Accepting new patients
FHPG, LLC Past Accepting new patients

Locations

205 Page Rd
Pinehurst, NC 28374
Phone (910) 295-9211

120 Page Rd N
Pinehurst, NC 28374
Phone (910) 715-8691

7 Regional Cir
Pinehurst, NC 28374
Phone (910) 715-8600

155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000

46 Memorial Dr
Pinehurst, NC 28374
Phone (910) 295-6782

Interoperability endpoints

  • Direct secure messaging: marcy.penrod.1@7598.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1699318592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 NAAB RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605924",
            "telephone_number": "317-338-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8333 NAAB RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605924",
            "telephone_number": "317-338-6666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10694 Coyote Run",
            "address_purpose": "LOCATION",
            "city": "Fishers",
            "state": "IN",
            "postal_code": "460388314",
            "country_code": "US",
            "telephone_number": "765-251-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENROD",
        "first_name": "MARCY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSN, AGPC-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71009503A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.