Active NPI
Carol Pena
- Public Health & General Preventive Medicine Physician
- Cedar Hill, TX
National Provider Identifier
1710502695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- 2083P0901X
- Practice address
- 412 Capricorn St
Cedar Hill, TX 75104-8106 - Phone
- (469) 445-7053
- NPI assigned
- Jun 16, 2020
- Last updated
- Jun 16, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | 2083P0901X | TX | Primary |
Addresses
Primary practice location
412 Capricorn St
Cedar Hill, TX 75104-8106
Mailing address
412 Capricorn St
Cedar Hill, TX 75104-8106
Phone (469) 445-7053
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Medistatmedical.org | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2083P0901X | TX | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592265600000",
"number": "1710502695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "412 CAPRICORN ST",
"city": "CEDAR HILL",
"state": "TX",
"postal_code": "751048106",
"telephone_number": "469-445-7053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "412 CAPRICORN ST",
"city": "CEDAR HILL",
"state": "TX",
"postal_code": "751048106",
"telephone_number": "469-445-7053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENA",
"first_name": "CAROL",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-16",
"last_updated": "2020-06-16",
"certification_date": "2020-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "TX",
"license": "2083P0901X",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Medistatmedical.org",
"affiliation": "N",
"endpointDescription": "Medistatmedical.org",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CONNECT URL",
"address_1": "412 Capricorn St",
"city": "Cedar Hill",
"state": "TX",
"country_code": "US",
"postal_code": "751048106",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Cedar Hill, TX
- Pcdi Healthcare and Consultants of Texas (PCDI Healthcare)
- Pcdi Healthcare and Consultants of Texas (PCDI Healthcare)
- Pcdi Healthcare and Consultants of Texas (PCDI Healthcare)
- Peaceful Rain Counseling Center PLLC
- Pediatric Dentistry of Cedar Hill, P.L.L.C. (Kids@Heart Pediatric Dentistry)
- Perfect Time Coaching LLC
- Brooklyn Ariel Pete, LPC, LCDC-I
- Danielle Peters
- Narin Petikun, O.D.
- Carolyn Rene Petrencik, FNP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.