Katia X Pendergrass, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

33600 Issued in TN

Practice address

397 Wallace Rd Ste 407
Nashville, TN 37211-8028

Phone

(615) 942-1040

Fax

(615) 942-1060

NPI assigned

Mar 31, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Pediatrix Medical Group of Tennessee, P.C.

  • Neonatal-Perinatal Medicine Physician
  • Nashville, TN
  • NPI 1497852107
  Medicare reassignment NPD

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1679278519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "397 WALLACE RD STE 407",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372118028",
            "telephone_number": "615-942-1040",
            "fax_number": "615-942-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "397 WALLACE RD STE 407",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372118028",
            "telephone_number": "615-942-1040",
            "fax_number": "615-942-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGRASS",
        "first_name": "KATIA",
        "middle_name": "X",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "33600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Pence, APN RN
• Mitchel Pendergast
• Sarah Ann Pendergraft
• Elizabeth Michele Pendergrass, PHARMD
• Judith Janell Pendergrass, RD
• Jennifer Pendergrast, APN-BC
• Alexis Pendley, APN
• John Pendy Jr.
• Evan Michael Pendygraft, OTD, OTR/L
• Lindsey Noelle Peng-Waters, MD

• Family Nurse Practitioner in Nashville, TN
• Providers in Nashville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.