Individual provider Active NPI

Denice M Penn, ARNP

  • Family Nurse Practitioner
  • Overland Park, KS
National Provider Identifier
1780772699
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
45288 Issued in KS
Practice address
4601 W 109TH St
Suite 350
Overland Park, KS 66211-1318
Phone
(913) 451-8555
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 45288 KS Primary

Addresses

Primary practice location

4601 W 109TH St
Suite 350
Overland Park, KS 66211-1318

Mailing address

14006 Eby St
Overland Park, KS 66221-2113
Phone (913) 851-4734

Other identifiers 1

IdentifierTypeStateIssuer
100643500AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20040625000762 KS Practitioner - Nurse Practitioner 5799761219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

3901 Rainbow Blvd
Kansas City, KS 66160-0001
Phone (913) 588-6431

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as apm
Quality
77.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
45288KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Current Accepting new patients
Kansas University Physicians Inc CurrentSince Aug 1, 2016 Accepting new patients
Kansas University Physicians Inc CurrentSince Aug 1, 2016 Accepting new patients
Kansas University Physicians Inc Past Accepting new patients

Locations

2000 Olathe
Kansas City, KS 66160
Phone (913) 588-1908

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

4000 Cambridge St
Kansas City, KS 66160
Phone (913) 588-3974

7405 Renner Rd
Shawnee Msn, KS 66217
Phone (913) 588-2200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780772699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14006 EBY ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662212113",
            "telephone_number": "913-851-4734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 W 109TH ST",
            "address_2": "SUITE 350",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111318",
            "telephone_number": "913-451-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENN",
        "first_name": "DENICE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "45288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100643500A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.