Timothy J Pendergrass, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1167979 Issued in TX

Practice address

4214 98TH St
Lubbock, TX 79423-3957

Phone

(806) 712-7878

Fax

(806) 722-7878

NPI assigned

Apr 4, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1952423766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 22ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101334",
            "telephone_number": "806-796-3000",
            "fax_number": "806-796-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 98TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794233957",
            "telephone_number": "806-712-7878",
            "fax_number": "806-722-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGRASS",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1167979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Adele Pelletier, RN
• Camilo Pena, MD
• Georgia Pena
• Jessica Pena
• Riley Pendergrass, CCC-SLP
• Mary Pendleton, DO
• Gerald Wayne Pennie, PHD, LPC, NCC
• Kara Beth Pepper, LMFT ASSOCIATE
• Marsha Renee Perales-Hull, M.D.
• Cesar Augusto Peralta

• Physical Therapist in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.