THERESA LOUISE PENNINGTON FNP-BC
NPI 1720445463
Nurse Practitioner - Family in Poplar Bluff, MO

Q: What is Theresa Pennington's NPI number?

The NPI number for Theresa Pennington is 1720445463. It was assigned to this individual provider in the NPPES registry on January 26, 2016.

Q: What is Theresa Pennington's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since January 26, 2016PECOS Enrolled

3100 OAK GROVE RD, POPLAR BLUFF, MO 63901(573) 776-2600 Get Directions Write a Review

NPPES record last updated: September 1, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 1, 2020, Nov 16, 2016, Jan 26, 2016 (3 updates tracked since 2016).

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About Theresa Louise Pennington Fnp-bc NPPES

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

THERESA LOUISE PENNINGTON FNP-BC (NPI 1720445463) is an individual family provider in Poplar Bluff, Missouri, licensed in Missouri (2016001340) and active in the NPI registry since January 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720445463

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameTHERESA LOUISE PENNINGTONCredential: FNP-BC

Location Address3100 OAK GROVE RDPoplar Bluff, MO 63901-1573

Mailing Address14030 Highway 160Harviell, MO 63945-8161 · (573) 714-4228

Phone(573) 776-2600

Sole ProprietorNo

Enumeration DateJanuary 26, 2016

Last NPPES UpdateSeptember 1, 20203 updates tracked since enumeration

NPPES CertifiedSeptember 1, 2020

✔ NPI 1720445463 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MO · 2016001340

3100 OAK GROVE RD, Poplar Bluff, MO 63901

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Theresa Louise Pennington Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

JOSHUA RYAN MORSE

Nurse Anesthetist, Certified Registered