PHILIP PENN (APRN, FNP-C) – Family Nurse Practitioner, NPI 1124766738

PHILIP PENN (APRN, FNP-C) is a healthcare provider. based in Louisville, Kentucky. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN, FNP-C. They hold a License No. 3017636 (KY). The NPI Number for PHILIP PENN (APRN, FNP-C) is 1124766738

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
PHILIP PENN (APRN, FNP-C)
NPI
1124766738
Phone
Not provided
Address
12201 BLUEGRASS PKWY
Enumeration Date
24 May 2022
Last Update Date
24 May 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5024915560
Graduation Year
2021 (5 years ago)
PAC ID
5193104180
Group Practice PAC ID
8325316516
Professional Enrollment ID
I20220622001287
Address ID
KY402202934LO2529XLNXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

7,343 NURSE PRACTITIONER in KY

Provider Addresses for PHILIP PENN (APRN, FNP-C)

  • 12201 BLUEGRASS PKWY

    LOUISVILLE, KY 402992361

    Phone:

    Type: Mailing

  • 3300 TATES CREEK RD

    LEXINGTON, KY 405023408

    Phone: (859) 266-2126

    Fax: (859) 266-5353

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2022-06-22

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220622001287INurse PractitionerKYTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes353133$0
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes14567$0
99310Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes4746$0
99316Nursing facility discharge management, more than 30 minutes3434$0
View full utilization report →

Insurance plans in this area (ZIP 40299)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8325316516View full group profile
NameSpecialtyState
Nurse PractitionerKY
Nurse PractitionerTN
Family PracticeTN
Internal MedicineFL
Nurse PractitionerKY
Nurse PractitionerTN
Nurse PractitionerNC
Nurse PractitionerFL
Nurse PractitionerKY
Nurse PractitionerKY

Reviews

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Frequently asked questions

What number should I use to identify PHILIP PENN (APRN, FNP-C) for billing?
Administrative and clinical systems typically use NPI 1124766738 for PHILIP PENN (APRN, FNP-C).
Should I treat PHILIP PENN (APRN, FNP-C) as an active provider?
Patients and plans typically see PHILIP PENN (APRN, FNP-C) as active in the national extract.
What type of care does PHILIP PENN (APRN, FNP-C) provide?
PHILIP PENN (APRN, FNP-C)'s profile centers on Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Can patients visit PHILIP PENN (APRN, FNP-C) in Louisville, Kentucky?
For routing, start with Louisville, Kentucky for PHILIP PENN (APRN, FNP-C), then verify phone and hours locally.
Can I export PHILIP PENN (APRN, FNP-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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