Active NPI
Greg A Pendley, ATC, LAT
- Athletic Trainer
- Homewood, AL
National Provider Identifier
1093859068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 078
- Practice address
- 1901 Lakeshore Dr S
Homewood, AL 35209-6730 - Phone
- (205) 871-9663
- Fax
- (205) 879-0879
- NPI assigned
- Feb 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 078 | AL | Primary |
Addresses
Primary practice location
1901 Lakeshore Dr S
Homewood, AL 35209-6730
Mailing address
2274 White Way
Hoover, AL 35226-3126
Phone (205) 822-8860
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 078 | AL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093859068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2274 WHITE WAY",
"city": "HOOVER",
"state": "AL",
"postal_code": "352263126",
"telephone_number": "205-822-8860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 LAKESHORE DR S",
"city": "HOMEWOOD",
"state": "AL",
"postal_code": "352096730",
"telephone_number": "205-871-9663",
"fax_number": "205-879-0879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENDLEY",
"first_name": "GREG",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "ATC, LAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AL",
"license": "078",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homewood, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.