Active NPI
Kathy L Pendergraft
- Behavior Analyst
- Antlers, OK
National Provider Identifier
1083055933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 112 N High St
Antlers, OK 74523-2250 - Phone
- (580) 298-3001
- Fax
- (580) 298-5357
- NPI assigned
- Jul 8, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
112 N High St
Antlers, OK 74523-2250
Mailing address
PO Box 309
Antlers, OK 74523-0309
Phone (580) 298-3001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
307 SW B St
Antlers, OK 74523-3824
Phone (580) 326-8605
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quest Mhsa | Current | Accepting new patients |
Locations
307 SW B St
Antlers, OK 74523
Phone (580) 326-8605
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Antlers, OK
- NPI 1174776819
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580083200000",
"number": "1083055933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 309",
"city": "ANTLERS",
"state": "OK",
"postal_code": "745230309",
"telephone_number": "580-298-3001",
"fax_number": "580-298-5357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 N HIGH ST",
"city": "ANTLERS",
"state": "OK",
"postal_code": "745232250",
"telephone_number": "580-298-3001",
"fax_number": "580-298-5357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENDERGRAFT",
"first_name": "KATHY",
"middle_name": "L",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-08",
"last_updated": "2020-01-27",
"certification_date": "2020-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Antlers, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.