Individual provider Active NPI

Destiny Pegram

  • Child & Adolescent Psychiatry Physician
  • Bellaire, TX
National Provider Identifier
1033641808
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
V8363 Issued in TX
Practice address
6330 West Loop S Ste 200
Bellaire, TX 77401-2924
Phone
(508) 334-1000
NPI assigned
Mar 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X V8363 TX Primary
Psychiatry Physician 2084P0800X 281537 MA

Addresses

Primary practice location

6330 West Loop S Ste 200
Bellaire, TX 77401-2924

Mailing address

6330 West Loop S Ste 200
Bellaire, TX 77401-2924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240412001409 MA Practitioner - Psychiatry 2466726344 Reassigns benefits to 3 organizations
I20250918004774 TX Practitioner - Psychiatry 2466726344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Medical Branch at Galveston, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1102 Bates Ave
Houston, TX 77030-2698

PO Box
Dallas, TX 75284

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
281537MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VHM Services, Inc. CurrentSince Mar 10, 2025 Accepting new patients
VHM Services Inc CurrentSince Mar 10, 2025 Accepting new patients
High Point Treatment Center Inc. CurrentSince Oct 21, 2024 Accepting new patients
Texas Children's Physician Group CurrentSince Sep 8, 2025 Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Mar 13, 2024 Accepting new patients

Locations

75 Francis St
Boston, MA 02115

30 Meadowbrook Rd
Brockton, MA 02301
Phone (508) 408-6190

10 Meadowbrook Rd
Brockton, MA 02301
Phone (508) 584-9210

62 13th St
Charlestown, MA 02129
Phone (617) 724-3874

115 Lincoln St
Framingham, MA 01702
Phone (508) 383-1000

67 Union St
Natick, MA 01760
Phone (508) 383-1104

72 Kilburn St
New Bedford, MA 02740
Phone (774) 213-8448

1233 State Rd
Plymouth, MA 02360
Phone (508) 224-6527

6330 West Loop S
Ste 200
Bellaire, TX 77401
Phone (832) 822-1515

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

Interoperability endpoints

  • Direct secure messaging: dpegram605342@prddirect.texaschildrens.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1033641808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6330 WEST LOOP S STE 200",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774012924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6330 WEST LOOP S STE 200",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774012924",
            "telephone_number": "508-334-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEGRAM",
        "first_name": "DESTINY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "V8363",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "281537",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellaire, TX

Sources for this page

Verify at the official NPI Registry.