Individual provider Active NPI

Elizabeth Penner, M.D.

  • Psychiatry Physician
  • Omaha, NE
National Provider Identifier
1891138798
Registry record updated Aug 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
30532 Issued in NE
Practice address
42ND @ Dewey St
Omaha, NE 68198-1023
Phone
(402) 552-6244
NPI assigned
Apr 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 7853 NE
Psychiatry Physician 2084P0800X 30532 NE Primary

Addresses

Primary practice location

42ND @ Dewey St
Omaha, NE 68198-1023

Mailing address

988102 Nebraska Medical Ctr
Omaha, NE 68198-8102

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address EPENNER588589@DIRECT.MED.UTAH.EDU Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220822002869 UT Practitioner - Psychiatry 9032539184 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7853NEMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Behavioral Health Services Current Accepting new patients
University of Utah Behavioral Health Services CurrentSince May 10, 2022 Accepting new patients
University of Utah Behavioral Health Services Psychiatry CurrentSince May 10, 2022 Accepting new patients
University of Utah Behavioral Health Services Psychiatry Current Accepting new patients
University of Utah Pediatric Behavioral Health Services CurrentSince Jul 15, 2022 Accepting new patients
University of Utah Pediatric Behavioral Health Services CurrentSince Jul 15, 2022 Accepting new patients
Charles Drew Health Center Inc PastSince May 25, 2021 Accepting new patients

Locations

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

525 E 100 S
Ste 500
Salt Lake City, UT 84102
Phone (801) 519-7190

501 S Chipeta Way
Slc, UT 84108
Phone (801) 581-7951

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: epenner588589@direct.med.utah.edu
  • Direct secure messaging: elizabeth.pennermd.p1@direct.charlesdrew.nextgenshare.com

Organizations & group practices 7

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": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661644800000",
    "number": "1891138798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988102 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681988102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42ND @ DEWEY ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681981023",
            "telephone_number": "402-552-6244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNER",
        "first_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-10",
        "last_updated": "2022-08-28",
        "certification_date": "2022-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NE",
            "license": "7853",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NE",
            "license": "30532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "EPENNER588589@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.