Penny Rea, NP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

55370 Issued in ID

Practice address

5307 Green Valley PL
Nampa, ID 83686-5790

Phone

(208) 899-7105

NPI assigned

Mar 13, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Boise State Health Center

  • Student Health Clinic/Center
  • Boise, ID
  • NPI 1194865444
  NPD (past)

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

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1851832695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5307 GREEN VALLEY PL",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836865790",
            "telephone_number": "208-899-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5307 GREEN VALLEY PL",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836865790",
            "telephone_number": "208-899-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REA",
        "first_name": "PENNY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-13",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "ID",
            "license": "55370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katarzyna Marta Rathman, PA
• Donald G Rau, MD
• Matthew Rawlins, ATC, LAT
• Rayla Healthcare Services LLC
• Sarah Razer
• Kade Ready, PA-C
• Rebecca Holmstead, LLC
• Rebekah Scott, LLC
• Cody William Redd Johnson, LPC, NCC
• Phillip James Redd, DO

• Primary Care Nurse Practitioner in Nampa, ID
• Providers in Nampa, ID by specialty
• Primary Care Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; 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.