Leslie Pendergrass (NPI# 1639541857, PAC ID# 1456661974) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1639541857 |
| PAC ID by PECOS | 1456661974 |
| Professional Enrollment ID | I20151112000584 |
| Full Name | Leslie Pendergrass |
| Organization Legal Name | IVY CREEK OF ELMORE LLC |
| Address |
4412 Hogan Rd Deatsville AL 36022-3400 |
| Phone Number | 3345144851 |
| Gender | F |
| Graduation Year | 2014 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 8426075508 |
| Number of Group Practice Members | 23 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 010108 | PRATTVILLE BAPTIST HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 4412 Hogan Rd, Deatsville, AL 36022-3400 | 3345144851 | IVY CREEK OF ELMORE LLC |
| Organization Legal Name | IVY CREEK OF ELMORE LLC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brandi I Criswell | Nurse Practitioner | Ivy Creek of Elmore LLC | 807 Jackson Trace Rd, Wetumpka, AL 36092-1504 |
| Martin A Lyons Jr. | Family Medicine | Ivy Creek of Elmore LLC | 41 Cambridge Ct, Wetumpka, AL 36093-1261 |
| Janice M Seip | Certified Registered Nurse Anesthetist (crna) | Ivy Creek of Elmore LLC | 500 Hospital Dr, Wetumpka, AL 36092-1625 |
| Sherman L Armstrong | General Surgery | Ivy Creek of Elmore LLC | 515 Hospital Dr, Wetumpka, AL 36092-1626 |
| Brandy Erin Laurenzi | Nurse Practitioner | Ivy Creek of Elmore LLC | 41 Cambridge Ct, Wetumpka, AL 36093-1261 |
| Jeremy Taylor | Certified Registered Nurse Anesthetist (crna) | Ivy Creek of Elmore LLC | 500 Hospital Dr, Wetumpka, AL 36092-1625 |
| Jeana Ann Murphy | Nurse Practitioner | Ivy Creek of Elmore LLC | 41 Cambridge Ct, Wetumpka, AL 36093-1261 |
| James F Mracek Ii | Family Practice | Ivy Creek of Elmore LLC | 807 Jackson Trace Rd, Wetumpka, AL 36092-1504 |
| Street Address |
4412 HOGAN RD |
| City | DEATSVILLE |
| State | AL |
| Zip | 36022-3400 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bishoy T Samuel | Family Practice | Physical Express | 2175 Hwy 31 N, Deatsville, AL 36022 |
| Jill A Zimmerman | Nurse Practitioner | Alabama Post-acute Medical Service 1 PC | 65 Charlton Pl, Deatsville, AL 36022-2697 |
| Ashley E. Tippins | Nurse Practitioner | Alabama Post-acute Medical Service 1 PC | 65 Charlton Pl, Deatsville, AL 36022-2697 |
| Steven L Allen | Family Medicine | 2175 Us Hwy 31 N, Deatsville, AL 36022-2714 |
| City | DEATSVILLE |
| Zip Code | 36022 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | DEATSVILLE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Leslie Pendergrass.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.