Active NPI
Daniel Bernheim Penner, M.D.
- Gastroenterology Physician
- Prospect, KY
National Provider Identifier
1811124472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 18703
- Practice address
- 7211 Leafland PL
Prospect, KY 40059-9687 - Phone
- (502) 228-5589
- NPI assigned
- Jun 22, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 18703 | KY | |
| Gastroenterology Physician | 207RG0100X | 18703 | KY | Primary |
Addresses
Primary practice location
7211 Leafland PL
Prospect, KY 40059-9687
Mailing address
7211 Leafland PL
Prospect, KY 40059-9687
Phone (502) 228-5589
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18703 | KY | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245628800000",
"number": "1811124472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7211 LEAFLAND PL",
"city": "PROSPECT",
"state": "KY",
"postal_code": "400599687",
"telephone_number": "502-228-5589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7211 LEAFLAND PL",
"city": "PROSPECT",
"state": "KY",
"postal_code": "400599687",
"telephone_number": "502-228-5589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNER",
"first_name": "DANIEL",
"middle_name": "BERNHEIM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-22",
"last_updated": "2009-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "KY",
"license": "18703",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "KY",
"license": "18703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prospect, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.