Active NPI
Lara Penny, MD
- Family Medicine Physician
- Denver, CO
National Provider Identifier
1972591196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 39258
- Practice address
- 777 Bannock St # Mc1914
Denver, CO 80204-4597 - Phone
- (303) 602-4000
- Fax
- (303) 602-4064
- NPI assigned
- Oct 11, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 39258 | CO | Primary |
Addresses
Primary practice location
777 Bannock St # Mc1914
Denver, CO 80204-4597
Mailing address
777 Bannock St # Mc1914
Denver, CO 80204-4597
Phone (303) 602-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22782346 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39258 | CO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Denver Health and Hospital Authority | Current | Accepting new patients | |
| Denver Health and Hospital Authority | Current | Accepting new patients | |
| Denver Health and Hospital Authority | Past | Accepting new patients | |
| Clinica Campesina Family Health Services | Past | Accepting new patients |
Locations
777 Bannock St
#1914
Denver, CO 80204
Phone (303) 436-4282
777 Bannock St
Denver, CO 80204
12600 Albrook Dr
Denver, CO 80239
Phone (303) 602-4000
777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714
Interoperability endpoints
- lpenny10632@direct.dhha.org
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.
-
- General Practice Physician
- Denver, CO
- NPI 1477569838
-
- Psychiatric Hospital Unit
- Denver, CO
- NPI 1689624942
-
- Federally Qualified Health Center (FQHC)
- Thornton, CO
- NPI 1093702177
-
- Federally Qualified Health Center (FQHC)
- Denver, CO
- NPI 1922049014
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720656000000",
"number": "1972591196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 BANNOCK ST # MC1914",
"city": "DENVER",
"state": "CO",
"postal_code": "802044597",
"telephone_number": "303-602-4000",
"fax_number": "303-602-4064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 BANNOCK ST # MC1914",
"city": "DENVER",
"state": "CO",
"postal_code": "802044597",
"telephone_number": "303-602-4000",
"fax_number": "303-602-4064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNY",
"first_name": "LARA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-11",
"last_updated": "2024-07-11",
"certification_date": "2024-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "39258",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "22782346",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.