Individual provider Active NPI

Penelope McClendon, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Spring, TX
National Provider Identifier
1760884282
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP126322 Issued in TX
Practice address
440 Rayford Rd Ste 150
Spring, TX 77386-4169
Phone
(936) 539-4004
Fax
(281) 419-1395
NPI assigned
Sep 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP126322 TX Primary

Addresses

Primary practice location

440 Rayford Rd Ste 150
Spring, TX 77386-4169

Mailing address

605 S Conroe Medical Dr
Conroe, TX 77304-4722
Phone (936) 539-4004

Other practice location 1

605 S Conroe Medical Dr
Conroe, TX 77304-4722
Phone (936) 539-4004

Other identifiers 1

IdentifierTypeStateIssuer
4153132-01MedicaidTX

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141024000305 TX Practitioner - Nurse Practitioner 2567683170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

440 Rayford Rd
Suite 150
Spring, TX 77386-4169
Phone (936) 539-4004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP126322TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lone Star Community Health Center, Inc. CurrentSince Aug 17, 2020 Accepting new patients
Lone Star Community Health Center, Inc. CurrentSince Aug 17, 2020 Accepting new patients
Lone Star Community Health Center, Inc. Past Accepting new patients
Lone Star Community Health Center, Inc. Past Accepting new patients

Locations

13905 Grangerland Rd
Conroe, TX 77306

605 S Conroe Medical Dr
Conroe, TX 77304

440 Rayford Rd
Ste 150
Spring, TX 77386

9516 FM 1097 Rd W
Ste 140
Willis, TX 77318
Phone (936) 436-5540

Interoperability endpoints

  • Direct secure messaging: penelopemcclendon@lsfhc.allscriptsdirect.net
  • Direct secure messaging: penelope.mcclendon.1@31617.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.

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1760884282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S CONROE MEDICAL DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044722",
            "telephone_number": "936-539-4004",
            "fax_number": "936-539-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 RAYFORD RD STE 150",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773864169",
            "telephone_number": "936-539-4004",
            "fax_number": "281-419-1395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "605 S Conroe Medical Dr",
            "address_purpose": "LOCATION",
            "city": "Conroe",
            "state": "TX",
            "postal_code": "773044722",
            "country_code": "US",
            "telephone_number": "936-539-4004",
            "fax_number": "936-539-3635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLENDON",
        "first_name": "PENELOPE",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-17",
        "last_updated": "2023-03-07",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP126322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4153132-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

Verify at the official NPI Registry.