Kendra Jamila Pendergraph

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P14023 Issued in NC

Practice address

1608 Queen St Ste 114
Wilmington, NC 28401-5527

Phone

(919) 790-8580

NPI assigned

Dec 27, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1577404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1194364950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W WILLOWOOD LN",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467927",
            "telephone_number": "910-381-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 QUEEN ST STE 114",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284015527",
            "telephone_number": "919-790-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGRAPH",
        "first_name": "KENDRA",
        "middle_name": "JAMILA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-27",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P14023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rita Pellicciari, FNP
• Crystal Koren Pellom, LPC-A
• Maya Yakovlevna Peltsverger, MD
• Pelvic Prescription LLC
• Karen Pender
• Walter L Pendergrast, CRNA
• Prabhakar Damodar Pendse, M.D.
• Yen-Lin Peng, M.D.
• Michael Royce Penland, PH.D.
• Robert Penn, MD

• Clinical Social Worker in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; 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.