MRS. JOANNA PENNYWELL – Certified Registered Nurse Anesthetist, NPI 1144755984

Certified Registered Nurse Anesthetist

MRS. JOANNA PENNYWELL is a healthcare provider. based in Dearborn heights, Michigan. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 4704248741 (MI). The NPI Number for MRS. JOANNA PENNYWELL is 1144755984

Main info

Female

Sole Proprietor

9 Years Of Experience

Accepts Medicare Assignment

Name

MRS. JOANNA PENNYWELL

NPI

1144755984

Phone

(313) 401-6739

Address

24635 ETON AVE

Enumeration Date

1 May 2017

Last Update Date

29 October 2019

Doctor Profile

Medical School Name

OTHER

Secondary Phone

7342466000

Graduation Year

2017 (9 years ago)

PAC ID

0042589871

Group Practice PAC ID

2264334499

Professional Enrollment ID

I20170710002437

Address ID

MI481924668WY2333XAVEX300

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience32

Completeness75

Years active:9State licenses:1Digital endpointsOther names

2,692 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MI

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Provider Addresses for MRS. JOANNA PENNYWELL

24635, Eton Avenue, Dearborn Heights, Wayne County, Michigan, 48125, United States
DEARBORN HEIGHTS, MI 481251807
Phone: (313) 401-6739
Type: Mailing
2181, Sheraton Drive, Trenton, Wayne County, Michigan, 48183, United States
TRENTON, MI 481831944
Phone: (313) 401-6739
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: 2017-07-10

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

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
I20170710002437	I	Certified Registered Nurse Anesthetist (Crna)	MI	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.

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

HCPCS	Description	Services	Beneficiaries	Medicare allowed
00811	Anesthesia for other procedure on large bowel using an endoscope	18	18	$0

View full utilization report →

Insurance plans in this area (ZIP 48125)

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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: 2264334499View full group profile

Name	Specialty	State
JAMIE ETTAHER	Certified Registered Nurse Anesthetist (Crna)	MI
JOSEPH STEPULLA (RN)	Certified Registered Nurse Anesthetist (Crna)	MI
DR. KATHRYN SHANNON MALOY (M.D., MPH)	O B S T E T R I C S/ G Y N E C O L O G Y	OH
SCOTT E BOYD (PA-C)	Physician Assistant	MI
DR. MARCIA LYNNE VANDERBROEK (DO)	-	MI
DANIEL L LONGO (CRNA)	-	MI
DR. JOYCE LEON (M.D.)	-	MI
DR. ANTHONY DWAYNE WILLIAMS (M.D.)	Gastroenterology, Internal Medicine	MI
MARCIA B KENYON (CRNA)	Certified Registered Nurse Anesthetist (Crna)	MI
DR. DAVID L WOLF (D.O.)	-	MI

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Frequently asked questions

What is the standard ID for MRS. JOANNA PENNYWELL in the U.S.?

In the U.S., MRS. JOANNA PENNYWELL is identified by NPI 1144755984.

Quick check: is MRS. JOANNA PENNYWELL active?

Public NPPES data shows MRS. JOANNA PENNYWELL with an active NPI status right now.

What services align with MRS. JOANNA PENNYWELL's listing?

MRS. JOANNA PENNYWELL's public classification highlights Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.

Is MRS. JOANNA PENNYWELL tied to Dearborn Heights, Michigan?

If you are local to Dearborn Heights, Michigan, MRS. JOANNA PENNYWELL may be relevant to your search.

Who maintains MRS. JOANNA PENNYWELL's record?

Providers certify NPPES data; CMS hosts the public file you are viewing.