YASHATE KINKIA PENDERGRASS (NPI# 1508325242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508325242 |
| Entity Type | Individual |
| Full Name | YASHATE KINKIA PENDERGRASS |
| Other Name | YASHATE KINKIA PENDERGRASS |
| Credential | RN |
| Practice Address |
2159 Grove Landing Way Grovetown GA 30813-7017 |
| Practice Telephone | 8433563374 |
| Mailing Telephone | 8433563374 |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2019-03-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WC1500X |
Registered Nurse Specialization: Community Health |
107470 | SC | Nursing Service Providers |
| Street Address |
2159 GROVE LANDING WAY |
| City | GROVETOWN |
| State | GA |
| Zip Code | 30813-7017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598276412 | Georgia Dental Professionals, PC | Dentist | 9596 Bentley Dr., Grovetown, GA 30813 | 2017-10-18 |
| 1558891895 | Jennifer M Humm | Dentist | 250 Merridian Drive, Grovetown, GA 30813 | 2017-06-19 |
| 1710335443 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 435 Lewiston Rd, Grovetown, GA 30813 | 2016-06-03 |
| 1558727214 | Lynda R Green | Counselor | 426 Northrop Place, Grovetown, GA 30813 | 2016-01-11 |
| 1689002610 | Patriots Park Dental, LLC | Dentist | 701 Devika Drive, Ste 10, Grovetown, GA 30813 | 2013-10-30 |
| 1255680096 | David Schulte Jr. | Internal Medicine | 925 Branch Ct Ste 2101, Grovetown, GA 30813 | 2012-09-07 |
| 1548519481 | Ashley Roberts Saunders | Pharmacist | 869 Horizon South Parkway, Grovetown, GA 30813 | 2012-09-06 |
| 1447569694 | Wallace Allen Partridge Jr. | Pharmacist | 5104 Wrightsboro Rd., Fred's Pharmacy 1699, Grovetown, GA 30813 | 2010-10-05 |
| 1497908149 | Sharon M Blair | Registered Nurse | 7640 Pleasantville Way, Grovetown, GA 30813 | 2008-10-28 |
| 1710160791 | Rebecca Meek | Nurse Practitioner | 469 Lewiston Rd, Grovetown, GA 30813 | 2007-12-12 |
| Find all providers in zip 30813 | ||||
| Taxonomy Code | 163WC1500X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255967071 | Simran Kaur | Registered Nurse | 2252 Nellie Dr, Augusta, GA 30906-8964 | 2020-03-13 |
| 1124651914 | Gyneth Springs Givens | Registered Nurse | 30 Glen Ridge Ct, Covington, GA 30014-6080 | 2020-02-19 |
| 1760021448 | Kenneth Unuovurhaye | Registered Nurse | 2073 Corners Circle Trce, Lithonia, GA 30058-7993 | 2019-12-30 |
| 1063069391 | Mark Benson | Registered Nurse | 4176 Chatford Cv, Tucker, GA 30084-7907 | 2019-08-21 |
| 1083196836 | Peta-gaye C Pilote | Registered Nurse | 319 Regal Way E, Mcdonough, GA 30253 | 2018-08-29 |
| 1144701855 | Nadiyah Gardner | Registered Nurse | 1790 Mulkey Rd Ste 3b, Austell, GA 30106-1122 | 2018-08-22 |
| 1205324357 | Lona M Sims | Registered Nurse | 2113 Defoors Ferry Rd Nw Apt F5, Atlanta, GA 30318-2344 | 2018-04-24 |
| 1881108884 | Carol Lee Hadley | Registered Nurse | 10 Park Place South Se Ste 445, Atlanta, GA 30303-2913 | 2017-11-29 |
| 1164940235 | De Advance Home Healthcare Services Inc | Registered Nurse | 932 Landon Dr, Marietta, GA 30064-6421 | 2017-09-08 |
| 1467976811 | Talia Montoya Anderson | Registered Nurse | 927 N Hansell St, Thomasville, GA 31792-4542 | 2017-07-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.