Kiara Pendergraft, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

E-14748 Issued in TN

Practice address

1031 McIntosh Cir
Joplin, MO 64804-3643

Phone

(417) 347-1111

NPI assigned

May 1, 2020

Last updated

Apr 16, 2025By 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 2

Addresses

Other names 1

• Kiara Antuna Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Edward Via Col of Osteo Medicine-Carolinas Campus, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  AR

  Medicare reassignment Care Compare group NPD
• Ies Arkansas PLLC

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1598488090

  AR

  Medicare reassignment NPD
• Mercy Hospital Berryville

  • Critical Access Hospital
  • Berryville, AR
  • NPI 1457306326
  Medicare reassignment NPD

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

• Mercy Hospital Rogers

  dba Mercy Hospital Northwest Arkansas

  • General Acute Care Hospital
  • Rogers, AR
  • NPI 1316902414
  Care Compare affiliation

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1679194583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 W 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 MCINTOSH CIR",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043643",
            "telephone_number": "417-347-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGRAFT",
        "first_name": "KIARA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-01",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-14748",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "E-14748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "email",
            "affiliation": "N",
            "address_1": "1031 McIntosh Cir",
            "city": "Joplin",
            "state": "MO",
            "country_code": "US",
            "postal_code": "648043643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIARA",
            "last_name": "ANTUNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jami Elane Payton, FNP-C
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• Laura Helene Pellizzari, DPM
• Pelvic Health PT by Dr. Cortney, DPT, LLC
• Joseph Ray Pence, PA-C
• Ellen Jane Pendley, M.S.
• Amber Dawn Reichelle Penn, BSW, MAADC II
• Armyni T Perales
• Joseph Percyz
• Christine Perez

• Emergency Medicine Physician in Joplin, MO
• Providers in Joplin, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.