JOSEPH C. III PENICK (CRNA) – Registered Nurse, NPI 1184022964
Registered Nurse
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,710 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in GA
Provider Addresses for JOSEPH C. III PENICK (CRNA)
2855 OLD HIGHWAY 5
BLUE RIDGE, GA 305136248
Phone: (706) 632-3711
Fax: (706) 946-4430
Type: Mailing
1968 PEACHTREE RD., NW
ATLANTA, GA 303091281
Phone: (404) 351-1745
Fax: (404) 351-7121
Type: Location
2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER
FORT BRAGG, NC 283100001
Phone: (706) 768-0496
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $29.
Total Amount is formed as General ($29) + Research ($0) + Ownership ($0) = $29.
Last reported payment date: 2024-09-17 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($29).
Total Amount
$29
General + Research + Ownership
Payments
2
Total payment records
General Amount
$29
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Merck Sharp & Dohme LLC | $29 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-11-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20191119001178 | I | Certified Registered Nurse Anesthetist (Crna) | NC | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30513)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | NC | |
| Certified Registered Nurse Anesthetist (Crna) | NC | |
| Certified Registered Nurse Anesthetist (Crna) | NC | |
| H E M A T O L O G Y/ O N C O L O G Y | NC | |
| Certified Registered Nurse Anesthetist (Crna) | VA | |
| Certified Registered Nurse Anesthetist (Crna) | NC | |
| Nurse Practitioner | NC | |
| Physical Therapist In Private Practice | NC | |
| - | NC | |
| Certified Registered Nurse Anesthetist (Crna) | NC |
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