Mark Jacob Pendergrass, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2587 Issued in TN

Practice address

325 Sam Ridley Pkwy W
Smyrna, TN 37167-5625

Phone

(615) 239-0907

NPI assigned

Mar 30, 2013

Sex

Male

Sole proprietor

No

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

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rock Springs Family ChiropracticGroup PAC ID 7618113762, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Rock Springs Family Chiropractic

  • Chiropractor
  • Smyrna, TN
  • NPI 1124369806
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1364601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1891038642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 SAM RIDLEY PKWY W",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371675625",
            "telephone_number": "615-239-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 SAM RIDLEY PKWY W",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371675625",
            "telephone_number": "615-239-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGRASS",
        "first_name": "MARK",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-30",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sam Smiseth Pearson, M.D.
• Samuel Ward Peebles, PT
• Jada Renee Pellegrino
• Chandler Pera Pemberton, M.S., CCC-SLP
• Elizabeth A Pendergrass, D.C.
• Renee Penner
• Kala Jo Pennington, MS CCCSLP
• Matthew Penny
• Perfect Smiles Dental Center
• Matthew Lane Perkins, MD

• Chiropractor in Smyrna, TN
• Providers in Smyrna, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.