Individual provider Active NPI

James Pendergrass, LMFT

  • Marriage & Family Therapist
  • Macon, GA
National Provider Identifier
1588072995
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT001341 Issued in GA
Practice address
717 North Avenue
Macon, GA 31211-1418
Phone
(478) 475-4608
Fax
(478) 476-8397
NPI assigned
Jul 29, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT001341 GA Primary

Addresses

Primary practice location

717 North Avenue
Macon, GA 31211-1418

Mailing address

717 North Avenue
Macon, GA 31211-1418
Phone (478) 475-4608

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240906003349 GA Practitioner - Marriage and Family Therapist 3173063955 Practice locations: Macon, GA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

717 N Ave
Macon, GA 31211-1418
Phone (478) 475-4608

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Christian Counseling Center Inc Marriage & Family Therapist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1588072995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 NORTH AVENUE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312111418",
            "telephone_number": "478-475-4608",
            "fax_number": "478-476-8397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 NORTH AVENUE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312111418",
            "telephone_number": "478-475-4608",
            "fax_number": "478-476-8397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGRASS",
        "first_name": "JAMES",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-29",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.