NPIMap

Organization Active NPI

Jonathon Pendergrass, M.D.

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Mobile, AL
National Provider Identifier
1083913776
Registry record updated Mar 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
License
12457 Issued in AL
Legal business name
JONATHON PENDERGRASS, M.D.
Practice address
6801 Airport Blvd
WCC/Hbo
Mobile, AL 36608-3709
Phone
(251) 631-3534
Fax
(251) 631-3531
NPI assigned
Mar 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2011

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

Authorized official

Name
Jonathon Pendergrass, M.D.
Title
Owner
Phone
(251) 631-3534

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2083P0011X 12457 AL Primary

Addresses

Primary practice location

6801 Airport Blvd
WCC/Hbo
Mobile, AL 36608-3709

Mailing address

6801 Airport Blvd
WCC/Hbo
Mobile, AL 36608-3709
Phone (251) 631-3534

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300665600000",
    "number": "1083913776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 AIRPORT BLVD",
            "address_2": "WCC/HBO",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366083709",
            "telephone_number": "251-631-3534",
            "fax_number": "251-631-3531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 AIRPORT BLVD",
            "address_2": "WCC/HBO",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366083709",
            "telephone_number": "251-631-3534",
            "fax_number": "251-631-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHON PENDERGRASS, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-21",
        "last_updated": "2011-03-21",
        "status": "A",
        "authorized_official_last_name": "PENDERGRASS",
        "authorized_official_first_name": "JONATHON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "251-631-3534",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "AL",
            "license": "12457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.