Individual provider Active NPI

Danielle Howa Pendergrass, DNP, APRN, WHNP-BC

  • Women's Health Nurse Practitioner
  • Price, UT
National Provider Identifier
1225257819
Registry record updated Jan 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
319637-4405 Issued in UT
Practice address
77 S 600 E
Suite B
Price, UT 84501-3174
Phone
(435) 637-0313
Fax
(435) 637-0317
NPI assigned
Apr 24, 2007
Last updated
Jan 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 319637-4405 UT Primary

Addresses

Primary practice location

77 S 600 E
Suite B
Price, UT 84501-3174

Mailing address

77 S 600 E
Suite B
Price, UT 84501-3174
Phone (435) 637-0313

Other identifiers 1

IdentifierTypeStateIssuer
1225257819MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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

Enrollment IDStateProvider typePAC IDDetails
I20150901000523 UT Practitioner - Nurse Practitioner 9931249356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

590 E 100
Suite 7
Price, UT 84501-2600
Phone (435) 637-0313

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
18588CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Utah Womens Health LLC Women's Health CurrentSince May 1, 2018 Accepting new patients

Locations

590 E 100 N
Ste 7
Price, UT 84501
Phone (435) 613-0733

77 S 600 E
#B
Price, UT 84501
Phone (435) 637-0313

Interoperability endpoints

  • Direct secure messaging: danielle@euwhl-ut.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1225257819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 S 600 E",
            "address_2": "SUITE B",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845013174",
            "telephone_number": "435-637-0313",
            "fax_number": "435-637-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 S 600 E",
            "address_2": "SUITE B",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845013174",
            "telephone_number": "435-637-0313",
            "fax_number": "435-637-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGRASS",
        "first_name": "DANIELLE",
        "middle_name": "HOWA",
        "name_prefix": "Mrs.",
        "credential": "DNP, APRN, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "UT",
            "license": "319637-4405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225257819",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Price, UT

Sources for this page

Verify at the official NPI Registry.