Individual provider Active NPI

Lynn Marie Penney, NPP

  • Registered Nurse
  • Smithtown, NY
National Provider Identifier
1821149634
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
3715241 Issued in NY
Practice address
269 Middle Country Rd
Smithtown, NY 11787-3487
Phone
(631) 335-7106
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 3715241 NY Primary
Nurse Practitioner 363L00000X F4007251 NY

Addresses

Primary practice location

269 Middle Country Rd
Smithtown, NY 11787-3487

Mailing address

30 Wildwood la
Smithtown, NY 11787-3487
Phone (631) 656-8993

Other identifiers 1

IdentifierTypeStateIssuer
02553588MedicaidNY

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

State licenses

LicenseStateTypeSpecialty
3715241NYMDRegistered Nurse
F4007251NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Psychiatric Associates, University Faculty Practice Corpor PastSince Jul 23, 2015 Accepting new patients

Organizations & group practices 1

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1821149634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WILDWOOD LA",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873487",
            "telephone_number": "631-656-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 MIDDLE COUNTRY RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873487",
            "telephone_number": "631-335-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNEY",
        "first_name": "LYNN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "3715241",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F4007251",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02553588",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.