THERESA LOUISE PENNINGTON (FNP-BC) – Family Nurse Practitioner, NPI 1720445463
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for THERESA LOUISE PENNINGTON (FNP-BC)
14030 HIGHWAY 160
HARVIELL, MO 639458161
Phone: (573) 714-4228
Type: Mailing
Poplar Bluff Regional Medical Center, 3100, Oak Grove Road, Loma Linda, Poplar Bluff, Butler County, Missouri, 63901, United States
POPLAR BLUFF, MO 639011573
Phone: (573) 776-2600
Type: Location
14030 Highway 160
Harviell, MO 639458161
Phone: (573) 714-4228
Type: Location
3098 Oak Grove Rd
Poplar Bluff, MO 639018938
Phone: (573) 778-2600
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $176.
Total Amount is formed as General ($176) + Research ($0) + Ownership ($0) = $176.
Last reported payment date: 2024-08-22 • Largest payer in this snapshot: Boston Scientific Corporation ($161).
Total Amount
$176
General + Research + Ownership
Payments
3
Total payment records
General Amount
$176
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $161 |
| Otsuka America Pharmaceutical, Inc. | $14 |
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: 2017-01-26
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 |
|---|---|---|---|---|
| I20170126000064 | I | Nurse Practitioner | MO | 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 63945)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Radiation Oncology | FL | |
| Cardiovascular Disease (Cardiology) | MO | |
| - | MO | |
| Family Practice, Undersea And Hyperbaric Medicine | TX | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | MO | |
| P S Y C H I A T R Y | TX | |
| - | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| - | MO |
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