Individual provider Active NPI

Dannelle Nicole Penrod, FNP-BC

  • Family Nurse Practitioner
  • Gloucester, VA
National Provider Identifier
1831939081
Registry record updated May 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024190237 Issued in VA
Practice address
7547 Medical Dr Ste 2300
Gloucester, VA 23061-4351
Phone
(804) 210-1703
NPI assigned
May 27, 2024
Last updated
May 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2024

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 0024190237 VA Primary

Addresses

Primary practice location

7547 Medical Dr Ste 2300
Gloucester, VA 23061-4351

Mailing address

7547 Medical Dr Ste 2300
Gloucester, VA 23061-4351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20241021000567 VA Practitioner - Nurse Practitioner 3173055795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

120 Kings Way
Suite 3300 and 3500
Williamsburg, VA 23185-2511
Phone (757) 253-0051

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024190237VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc CurrentSince Sep 9, 2024 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services Inc CurrentSince Sep 9, 2024 Accepting new patients
Riverside Physician Services Inc Past Accepting new patients

Locations

7547 Medical Dr
Ste 2300
Gloucester, VA 23061
Phone (757) 221-0750

850 Enterprise Pkwy
Ste 2000
Hampton, VA 23666
Phone (757) 534-6109

101 Philip Roth St
Newport News, VA 23606
Phone (757) 599-6333

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

20486 Market St
Onancock, VA 23417
Phone (757) 302-2700

120 Kings Way
Ste 3300
Williamsburg, VA 23185
Phone (757) 221-0750

Interoperability endpoints

  • Direct secure messaging: dpenrod161654@direct.rivhs.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, 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": "1716768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716768000000",
    "number": "1831939081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7547 MEDICAL DR STE 2300",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7547 MEDICAL DR STE 2300",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614351",
            "telephone_number": "804-210-1703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENROD",
        "first_name": "DANNELLE",
        "middle_name": "NICOLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-27",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024190237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, VA

Sources for this page

Verify at the official NPI Registry.