Debra Marie Pendergast, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

847-033 Issued in WI

Practice address

4202 W Oakwood Park CT Ste 200
Franklin, WI 53132-9565

Phone

(414) 423-5250

NPI assigned

Mar 14, 2008

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dpendergast42233@direct.myadvocateaurora.org

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.

• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1801941075
  NPD (past)
• Aurora Quick Care, LLC

  • Nurse Practitioner
  • Mequon, WI
  • NPI 1609820729
  NPD (past)
• Oak Creek Medical & Occupational L.L.C.

  • Multi-Specialty Clinic/Center
  • Oak Creek, WI
  • NPI 1356414288
  NPD (past)
• Oak Creek Medical & Pccupational, LLC

  • Physical Therapist
  • Oak Creek, WI
  • NPI 1932211141
  NPD (past)

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1992976286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4202 W OAKWOOD PARK CT STE 200",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531329565",
            "telephone_number": "414-423-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4202 W OAKWOOD PARK CT STE 200",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531329565",
            "telephone_number": "414-423-5250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4202 W Oakwood Park Ct",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "WI",
            "postal_code": "531328131",
            "country_code": "US",
            "telephone_number": "414-423-5250",
            "fax_number": "414-423-5256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENDERGAST",
        "first_name": "DEBRA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-14",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "847-033",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "65923-030",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpendergast42233@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4202 W Oakwood Park Ct Ste 200",
            "city": "Franklin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531329565",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4202 W Oakwood Park Ct Ste 200",
            "city": "Franklin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531329565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren Marie Pawlowski, DPT
• Pederson Homecare LLC Bda Visiting Angels
• Pediatric Diagnostic Imaging, S.C.
• Eric Pelky
• Katherine Theresa Pellino, MD
• Joann M Pennington, P.A.
• William T Pennington, MD
• Kathleen P Penzenstadler, M.D.
• Performance Enhancement
• Performance Enhancement Health Services, S.C.

• Nurse Practitioner in Franklin, WI
• Providers in Franklin, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.