Individual provider Active NPI

Penelope Smith Hunsucker, NURSE PRACTITIONER

  • Obstetrics & Gynecology Nurse Practitioner
  • Hickory, NC
National Provider Identifier
1720002710
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
800079 Issued in NC
Practice address
3070 11TH Avenue Dr SE
Hickory, NC 28602-8336
Phone
(828) 695-5822
Fax
(828) 695-4437
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 800079 NC Primary

Addresses

Primary practice location

3070 11TH Avenue Dr SE
Hickory, NC 28602-8336

Mailing address

6600 Central Dr
Conover, NC 28613-7722
Phone (828) 695-5822

Other identifiers 1

IdentifierTypeStateIssuer
800079OtherNCSTATE PRESCRIBING NUMBER

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
800079NCMDObstetrics & Gynecology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1720002710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 CENTRAL DR",
            "city": "CONOVER",
            "state": "NC",
            "postal_code": "286137722",
            "telephone_number": "828-695-5822",
            "fax_number": "828-695-4437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 11TH AVENUE DR SE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286028336",
            "telephone_number": "828-695-5822",
            "fax_number": "828-695-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNSUCKER",
        "first_name": "PENELOPE",
        "middle_name": "SMITH",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NC",
            "license": "800079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PRESCRIBING NUMBER",
            "identifier": "800079",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.