Active NPI
Joy Susan Pendergrass, FNP,BC
- Family Nurse Practitioner
- Fernandina Beach, FL
National Provider Identifier
1639561160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 9364981
- Practice address
- 536 Spanish Way W
Fernandina Beach, FL 32034-9244 - Phone
- (904) 310-9468
- NPI assigned
- Feb 20, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 9364981 | FL | Primary |
Addresses
Primary practice location
536 Spanish Way W
Fernandina Beach, FL 32034-9244
Mailing address
536 Spanish Way W
Fernandina Beach, FL 32034-9244
Phone (904) 310-9468
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9364981 | FL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424390400000",
"number": "1639561160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "536 SPANISH WAY W",
"city": "FERNANDINA BEACH",
"state": "FL",
"postal_code": "320349244",
"telephone_number": "904-310-9468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "536 SPANISH WAY W",
"city": "FERNANDINA BEACH",
"state": "FL",
"postal_code": "320349244",
"telephone_number": "904-310-9468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENDERGRASS",
"first_name": "JOY",
"middle_name": "SUSAN",
"name_prefix": "Mrs.",
"credential": "FNP,BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-20",
"last_updated": "2015-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "9364981",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fernandina Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.