Individual provider Active NPI

Jessica Pendleton, RN

  • Registered Nurse
  • Austin, TX
National Provider Identifier
1639977416
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1125893 Issued in TX
Practice address
5012 Ranch Road 620 N
Austin, TX 78732-1846
Phone
(512) 851-1011
NPI assigned
Mar 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1125893 TX Primary

Addresses

Primary practice location

5012 Ranch Road 620 N
Austin, TX 78732-1846

Mailing address

1616 W 6TH St Apt 208
Austin, TX 78703-5002
Phone (515) 554-2847

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1125893TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1741219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1639977416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 W 6TH ST APT 208",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787035002",
            "telephone_number": "515-554-2847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5012 RANCH ROAD 620 N",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787321846",
            "telephone_number": "512-851-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDLETON",
        "first_name": "JESSICA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1125893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; 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.