Logan B. Pendergrass, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8854 Issued in TN

Practice address

1422 Old Weisgarber Rd
Knoxville, TN 37909-1293

Phone

(865) 558-4480

Fax

(865) 558-4481

NPI assigned

Feb 16, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: logan.pendergrass.p1@direct.orthotn.nextgenshare.com

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.

• Hovis Orthopaedic Clinic PC

  • Orthopaedic Surgery Physician
  • Knoxville, TN
  • NPI 1053392043
  NPD (past)
• Orthotennessee

  • Multi-Specialty Clinic/Center
  • Knoxville, TN
  • NPI 1841508751

  Physical Therapist

  NPD (past)
• Orthotennessee, PC

  • Multi-Specialty Clinic/Center
  • Powell, TN
  • NPI 1518043751
  NPD (past)

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

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1124325808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 OLD WEISGARBER RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091293",
            "telephone_number": "865-558-4480",
            "fax_number": "865-558-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 OLD WEISGARBER RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091293",
            "telephone_number": "865-558-4480",
            "fax_number": "865-558-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGRASS",
        "first_name": "LOGAN",
        "middle_name": "B.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-16",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "8854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5792655",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1523478",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "4288724",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01085928",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alice Jean Pelletier, DO
• Reuben N Pelot III, DDS
• Kristie Pelton, MD
• Larry Pemberton, PH.D.
• Brent Alan Pendergast, P.T.
• William R Pendergrass, PT
• Hannah Pendleton, BCBA, LBA
• Sarah Willard Penegar, PH. D.
• Peninsula Outpatient Pharmacy - Knox
• Margie Nell Penn

• Physical Therapist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; 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.