Traci M Penner, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

112074 Issued in NE

Practice address

3610 Richmond Cir Ste 100
Grand Island, NE 68803-3910

Phone

(308) 398-6400

Fax

(308) 398-6408

NPI assigned

Jul 27, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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

Specialty

Nurse Practitioner

Education

Creighton University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Community Health IncGroup PAC ID 1355394040, shared by 5 NPIs, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• York General Health Care Services Hospital, York, NE, CCN 281336
• Memorial Hospital Hospital, Aurora, NE, CCN 281320

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/a4c7307b-5132-41db-ae59-8b3c5b480948/

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.

• Crete Area Medical Center

  • Critical Access Hospital
  • Crete, NE
  • NPI 1063463958
  Medicare reassignment NPD
• Crete Area Medical Center

  • Family Medicine Physician
  • Crete, NE
  • NPI 1245281138
  Medicare reassignment NPD
• Grand Island Radiology Associates PC

  • Diagnostic Radiology Physician
  • Grand Island, NE
  • NPI 1932136405
  Medicare reassignment NPD
• Memorial Community Health, Inc

  • Critical Access Hospital
  • Aurora, NE
  • NPI 1063429694
  Medicare reassignment NPD
• Memorial Community Health, Inc

  • Family Medicine Physician
  • Aurora, NE
  • NPI 1881603850
  Medicare reassignment NPD
• Midwest Emergency Grand Island Inc

  • Emergency Medicine Physician
  • Grand Island, NE
  • NPI 1508357930
  Medicare reassignment NPD
• York General Hospital

  • Critical Access Hospital
  • York, NE
  • NPI 1588764898
  Medicare reassignment NPD
• York General Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • York, NE
  • NPI 1982704250
  Medicare reassignment NPD
• Twin Rivers Urgent Care LLC

  • Family Medicine Physician
  • Grand Island, NE
  • NPI 1639248560
  Medicare reassignment
• Cambridge Memorial Hospital Inc

  • Family Medicine Physician
  • Cambridge, NE
  • NPI 1740462654
  NPD
• Crete Area Medical Center

  • Rural Health Clinic/Center
  • Friend, NE
  • NPI 1699217588
  NPD
• Memorial Community Health Inc

  • Rural Health Clinic/Center
  • Aurora, NE
  • NPI 1083326193
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Community Health, Inc

  • Critical Access Hospital
  • Aurora, NE
  • NPI 1063429694
  Care Compare affiliation
• York General Hospital

  • Critical Access Hospital
  • York, NE
  • NPI 1588764898
  Care Compare affiliation

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1891248720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1725",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688021725",
            "telephone_number": "308-398-6400",
            "fax_number": "308-398-6408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 RICHMOND CIR STE 100",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688033910",
            "telephone_number": "308-398-6400",
            "fax_number": "308-398-6408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNER",
        "first_name": "TRACI",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-27",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A144741",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "112074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Pederson
• Chelsea Mae Pedroza, APRN
• Ruth Marolina Pelico
• Jennifer Pelster
• Jordyn Elizabeth Penner, COTA/L
• Brisa Perez Chan
• Gladys Mildred Perez Chan
• Yusniel Perez Suarez
• Audrey Perez
• Celestino Perez

• Family Nurse Practitioner in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Family Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.