Tiffany T Pendergrass, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

32294 Issued in TN

Practice address

689 Medical Park Dr Ste 201
Lenoir City, TN 37772-5797

Phone

(865) 988-6575

Fax

(865) 988-6066

NPI assigned

May 29, 2023

Last updated

May 29, 2023By the provider in NPPES

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

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Knoxville Nephrology Associates, LLCGroup PAC ID 9537388525, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tpendergrass36557@direct.davitaphysiciansolutions.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Knoxville Nephrology Associates LLC

  • Nephrology Physician
  • Knoxville, TN
  • NPI 1184031965
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1685318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685318400000",
    "number": "1194418939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "689 MEDICAL PARK DR STE 201",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377725797",
            "telephone_number": "865-988-6575",
            "fax_number": "865-988-6066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "689 MEDICAL PARK DR STE 201",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377725797",
            "telephone_number": "865-988-6575",
            "fax_number": "865-988-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGRASS",
        "first_name": "TIFFANY",
        "middle_name": "T",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-29",
        "last_updated": "2023-05-29",
        "certification_date": "2023-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "32294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly C. Payne
• Megan Lindsay Pearce
• Tonya Pearson
• Pediatric Choice LLC
• Pediatric Consultants of Lenoir City
• Laurel Baye Penley
• Performance Eyecare Clinic, Inc.
• Performance Eyecare PLLC
• Stephen D Pershing, M.D. LLC
• Joseph C. Petit, MD

• Nurse Practitioner in Lenoir City, TN
• Providers in Lenoir City, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2023; 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.

Verify at the official NPI Registry.