Carlina Lopez Pendon, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10717 Issued in TN

Practice address

1508 Tombras Avenue
East Ridge, TN 37412-2720

Phone

(423) 867-4969

Fax

(423) 867-4971

NPI assigned

Mar 31, 2006

Last updated

Mar 3, 2015By 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 1

Addresses

Other identifiers 3

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

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Your Good Health, LLCGroup PAC ID 3173615838, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carlina.pendon@ingoodhealth.directbygreenway.com
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72916

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.

• Your Good Health, LLC

  dba In Good Health

  • Primary Care Clinic/Center
  • East Ridge, TN
  • NPI 1386864296
  Medicare reassignment Care Compare group NPD
• Cardiovascular Group, PC

  dba Chattanooga Heart Institute

  • Cardiovascular Disease Physician
  • Chattanooga, TN
  • NPI 1912906181
  NPD (past)

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1831150549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 TOMBRAS AVENUE",
            "city": "EAST RIDGE",
            "state": "TN",
            "postal_code": "374122720",
            "telephone_number": "423-867-4969",
            "fax_number": "423-867-4971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 TOMBRAS AVENUE",
            "city": "EAST RIDGE",
            "state": "TN",
            "postal_code": "374122720",
            "telephone_number": "423-867-4969",
            "fax_number": "423-867-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDON",
        "first_name": "CARLINA",
        "middle_name": "LOPEZ",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "10717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1502791",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TENNESSEE",
            "identifier": "4176928",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194230287A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kurtisha Norris
• Jancy Allison Parkerson, DMD
• Kalpeshkumar Rameshbhai Patel, PHARMACIST
• Kenneth W Patric Jr., MD
• Bruce Allen Pendley, MD
• Tessa K Poteralski, PT
• Puckett Emergency Medical Services, LLC (Puckett Emergency Medical Services)
• Puckett Med Van LLC
• Emily Raycraft
• Katelyn Joan Renard, PT, DPT

• Family Nurse Practitioner in East Ridge, TN
• Providers in East Ridge, 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 3, 2015; 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.