Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gary Penner

Individual provider Family Medicine Physician · NPI 1689740136

Gary Penner is a Family Medicine Physician in Fairfax, Virginia. Licensed in Nebraska and Virginia. Registered with an NPI since 2006.

Licensed in
NE, VA
In the registry since
2006
Specialties on file
2

Practice location Address checks out

11910 Parkside Dr
Fairfax, VA 22033-2648
Phone: (202) 816-2832
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 0101027481 (VA)
Family Medicine Physician Taxonomy 207Q00000X · Licence 12875 (NE)

Record details

NPI number1689740136
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 27, 2006
Last updated in NPPESMarch 8, 2022
Certification dateMarch 8, 2022
Mailing address11910 Parkside Dr, Fairfax, VA 22033-2648

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