Individual provider Active NPI

Penny S Mulberry, MD

  • Hospitalist Physician
  • Jacksonville, FL
National Provider Identifier
1881898542
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME131144 Issued in FL
Practice address
820 Prudential Dr Ste 304
Jacksonville, FL 32207-8205
Phone
(904) 202-3860
Fax
(904) 202-3846
NPI assigned
Jun 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME131144 FL
Hospitalist Physician 208M00000X ME131144 FL Primary

Addresses

Primary practice location

820 Prudential Dr Ste 304
Jacksonville, FL 32207-8205

Mailing address

PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-1032

Other identifiers 2

IdentifierTypeStateIssuer
020230500MedicaidFL
387539MedicaidSC

Other names 1

  • Ms. Penny S Stanley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150923001320 SC Practitioner - Internal Medicine 7618166943 Reassigns benefits to 1 organization
I20170410002585 FL Practitioner - HospitalistPractitioner - Internal Medicine 7618166943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
University of South Carolina School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

820 Prudential Dr
Suite 304
Jacksonville, FL 32207-8205
Phone (904) 202-3860

Hospital & facility affiliations

  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Baptist Medical Center - Nassau Hospital, Fernandina Beach, FL, CCN 100140
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
  • Ed Fraser Memorial Hospital Hospital, Macclenny, FL, CCN 100134

Merit-based Incentive Payment System (MIPS)

Final score
95.44 of 100Reported as apm
Quality
84.21
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME131144FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Primary Care Inc. Internal Medicine CurrentSince Apr 26, 2017 Accepting new patients
Baptist Primary Care Inc CurrentSince Apr 26, 2017 Accepting new patients
Baptist Primary Care Inc Internal Medicine Current Accepting new patients
Apogee Medical Group South Carolina Internal Medicine CurrentSince Aug 18, 2015 Accepting new patients

Locations

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

820 Prudential Dr
Ste 304
Jacksonville, FL 32207
Phone (904) 202-3860

1 Saint Francis Dr
Greenville, SC 29601
Phone (864) 225-1000

Interoperability endpoints

  • Direct secure messaging: pmulberry28304@baptisthealthsystemjacksonville.direct-ci.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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1881898542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-1032",
            "fax_number": "904-376-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 PRUDENTIAL DR STE 304",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078205",
            "telephone_number": "904-202-3860",
            "fax_number": "904-202-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULBERRY",
        "first_name": "PENNY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME131144",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME131144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020230500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387539",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENNY",
            "last_name": "STANLEY",
            "middle_name": "S",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.