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LANDON PENDERGRASS M.D. NPI 1710985254


NPI Information

NPI: 1710985254
Provider Name: LANDON PENDERGRASS, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
777 WASHINGTON AVE
SUITE 410
MEMPHIS, TN
ZIP 38105
Phone: (901) 523-2945
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Landon Pendergrass, M.D. is a pediatrics in Memphis, TN. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Landon Pendergrass, M.D. NPI is 1710985254. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

777 WASHINGTON AVE
SUITE 410
MEMPHIS, TN
ZIP 38105-550
Phone: (901) 523-2945

The enumeration date for this NPI number is 7/8/2005 and was last updated on 6/12/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics19808TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1F10817MEDICARE UPIN
23046506MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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