BRIANNA MICHELLE PENDERGRASS (NPI# 1518522283) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518522283 |
| Entity Type | Individual |
| Full Name | BRIANNA MICHELLE PENDERGRASS |
| Credential | FNP-BC |
| Practice Address |
1082 Gluckstadt Rd Madison MS 39110-7243 |
| Mailing Address |
110 Villa Way Clinton MS 39056-6106 |
| Practice Telephone | 6017075621 |
| Mailing Telephone | 6017207166 |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2020-09-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 25671 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
1082 GLUCKSTADT RD |
| City | MADISON |
| State | MS |
| Zip Code | 39110-7243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952383812 | Sonya K. Goodin | Nurse Practitioner | 1082 Gluckstadt Rd, Madison, MS 39110 | 2005-11-16 |
| 1730799834 | Emilye Walker Welch | Nurse Practitioner | 1082 Gluckstadt Rd, Madison, MS 39110-7243 | 2020-08-04 |
| 1245581370 | Psp Medical Clinic, LLC | Clinic/Center | 1082 Gluckstadt Rd, Madison, MS 39110 | 2012-09-28 |
| 1710075031 | Gary Lamar Hamil | Nurse Practitioner | 1082 Gluckstadt Rd, Madison, MS 39110 | 2006-10-11 |
| 1407817240 | Reginald D Rigsby | Family Medicine | 1082 Gluckstadt Rd, Madison, MS 39110-7243 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134784689 | Therapy South - Gluckstadt LLC | Physical Therapist | 1716 Us 51, Ste N, Madison, MS 39110 | 2019-05-09 |
| 1871054098 | Summit Medical Solutions | Durable Medical Equipment & Medical Supplies | 107 Azalea Street, Madison, MS 39110 | 2019-03-29 |
| 1912488198 | Madison Medical Compounding Pharmacy | Pharmacy | 111 Fountains Blvd. Building B Ste. A, Madison, MS 39110 | 2018-08-24 |
| 1679061469 | Nuvena Vein Clinic | Anesthesiology | 120 Fountains Blvd, Madison, MS 39110 | 2018-04-26 |
| 1467960484 | Brick City Drugs, LLC | Durable Medical Equipment & Medical Supplies | 159 Fountains Blvd, Madison, MS 39110 | 2018-01-11 |
| 1093227589 | Hannah Monk Hawthorne | Counselor | 930 Ebenezer Blvd., Suite D, Madisin, MS 39110 | 2017-10-25 |
| 1548786650 | Kimberly Allen | Pharmacist | 1100 Us- 51, Madison, MS 39110 | 2017-08-21 |
| 1891218186 | Delta Elizabeth Stark | Chiropractor | 1085 Gluckstadt Rd., Bld 300 Ste E, Madison, MS 39110 | 2017-07-19 |
| 1861914848 | Laura Hartlein | Dietitian, Registered | 200 Park Circle Dr. #2, Flowood, MS 39110 | 2017-07-12 |
| 1831620608 | Ona Irby | Occupational Therapist | 105 Munich Dr, Madison, MS 39110 | 2017-03-23 |
| Find all providers in zip 39110 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275159998 | Beam Healthcare, Sc | Family Medicine | 25 W Main St Fl 5, Madison, WI 53703-3399 | 2020-06-18 |
| 1598390932 | Ashley Rae Woodcock | Family Medicine | 844 Slaughter Rd, Madison, AL 35758-8836 | 2020-03-05 |
| 1255974952 | Integrative Health Center of Central Wisconsin LLC | Family Medicine | 3205 E Washington Ave Ste A, Madison, WI 53704-4332 | 2019-10-25 |
| 1538628961 | Heidi Hollinger | Family Medicine | 145 Kelso Blvd, Madison, AL 35756-4285 | 2019-03-15 |
| 1902364383 | Robert Thomas Pepper | Family Medicine | 1740 Lions Club Rd Ste 100, Madison, GA 30650-4762 | 2019-03-05 |
| 1497240485 | Doctor-patient Medicine Inc | Family Medicine | 101 Westover Cir Ste B, Madison, AL 35758-4900 | 2018-06-22 |
| 1457863243 | Debra Ann Mandarino | Family Medicine | 4223 Mandan Cres # 4223, Madison, WI 53711-3063 | 2017-11-02 |
| 1407367683 | Roxanne L Brown | Family Medicine | 1210 Briarville Rd Bldg F, Madison, TN 37115-5136 | 2017-10-16 |
| 1871023242 | Tulio Romulo Figarola | Family Medicine | 225 Mill Walk Ct, Madison, AL 35758-1565 | 2017-06-18 |
| 1649704586 | Zaunklay Finnila | Family Medicine | 540 Hughes Rd Ste 4, Madison, AL 35758-8959 | 2017-04-18 |
| Find all providers in MADISON | ||||
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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.