Alicia Pendergrass, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

19686 Issued in SC

Practice address

1 Wellness Blvd Ste 203
Irmo, SC 29063-2873

Phone

(803) 749-9920

Fax

(803) 749-9916

NPI assigned

Oct 7, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.09 of 100Reported as group

Quality

68.87

Promoting interoperability

100

Improvement activities

40

Cost

78.11

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Lexington Health Inc

  • Sports Medicine (Orthopaedic Surgery) Physician
  • West Columbia, SC
  • NPI 1710634753
  Medicare reassignment Care Compare group NPD
• Lexington County Health Services District Inc

  • General Acute Care Hospital
  • West Columbia, SC
  • NPI 1356366314
  NPD
• Lexington Health Inc

  • Obstetrics & Gynecology Physician
  • West Columbia, SC
  • NPI 1487252508
  NPD
• Lexington Health Inc

  • Internal Medicine Physician
  • West Columbia, SC
  • NPI 1942190988
  NPD

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1063883767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069",
            "telephone_number": "803-749-9920",
            "fax_number": "803-749-9916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WELLNESS BLVD STE 203",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632873",
            "telephone_number": "803-749-9920",
            "fax_number": "803-749-9916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "811 W Main St Ste 201&209",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "SC",
            "postal_code": "290722507",
            "country_code": "US",
            "telephone_number": "803-785-4777",
            "fax_number": "803-358-6240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENDERGRASS",
        "first_name": "ALICIA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-07",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "SC",
            "license": "19686",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3611",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apendergrass75414@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "1 Wellness Blvd Ste 203",
            "city": "Irmo",
            "state": "SC",
            "country_code": "US",
            "postal_code": "290632873",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apendergrass75414@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "811 W Main St Ste 201&209",
            "city": "Lexington",
            "state": "SC",
            "country_code": "US",
            "postal_code": "290722507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Adam Douglas Paxton
• Christina Marie Payette, PHARMD
• Melanie Peagler
• Emily Peak
• Mark G. Pelletier, D.D.S.
• Nicole Janay Perez
• Stephanie C Peterson, PA
• Peter M. Petrusic, MS, ATC, PTA
• Margaret Livingston Phillips, DMD
• Jeanita Dunlap Pinkerton, PHARM.D.

• Family Nurse Practitioner in Irmo, SC
• Providers in Irmo, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.