MRS. PHYLLIS A PENGELLY WHNP
NPI 1265468912
Nurse Practitioner - Women's Health in Bend, OR

Q: What is Phyllis Pengelly's NPI number?

The NPI number for Phyllis Pengelly is 1265468912. It was assigned to this individual provider in the NPPES registry on June 24, 2006.

Q: What is Phyllis Pengelly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.

Q: When was this NPI record last updated?

The NPPES record for Phyllis Pengelly was last updated on November 14, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 24, 2006

2330 NE DIVISION ST, SUITE 7, BEND, OR 97701(503) 775-4931(503) 788-7285 Get Directions Write a Review

NPPES record last updated: November 14, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mrs. Phyllis A Pengelly Whnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. PHYLLIS A PENGELLY WHNP (NPI 1265468912) is an individual women's health provider in Bend, Oregon, licensed in Oregon (200350128NP) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1265468912

Entity TypeIndividualFemale

Primary Taxonomy363LW0102X

Provider Legal NameMRS. PHYLLIS A PENGELLYCredential: WHNP

Location Address2330 NE DIVISION ST, SUITE 7Bend, OR 97701-3530

Mailing Address3727 Ne Martin Luther King Jr Blvd, Attn: CredentialingPortland, OR 97212-1112 · (503) 775-4931 · Fax (503) 788-7285

Phone(503) 775-4931

Fax(503) 788-7285

Sole ProprietorNo

Enumeration DateJune 24, 2006

Last NPPES UpdateNovember 14, 2011

✔ NPI 1265468912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Women's HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LW0102X

License✔ Licensed in OR · 200350128NP

2330 NE DIVISION ST, Bend, OR 97701

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Other Identifiers 1

Medicaid270097OR

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARIA VACARELLA C.N.M.

Advanced Practice Midwife

2330 NE DIVISION ST, SUITE 7
BEND, OR 97701

Deschutes County (503) 775-4931

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phyllis Pengelly's NPI number?

The NPI number for Phyllis Pengelly is 1265468912. It was assigned to this individual provider in the NPPES registry on June 24, 2006.

Where is Phyllis Pengelly located?

Phyllis Pengelly practices at 2330 NE Division St Suite 7, Bend, OR 97701. The listed phone number is (503) 775-4931.

What is Phyllis Pengelly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.

When was this NPI record last updated?

The NPPES record for Phyllis Pengelly was last updated on November 14, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.