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DR. W. JEFFERSON PENDERGRAST JR. M.D.
NPI 1376603894
Specialist in Atlanta, GA

Active since December 12, 2006
2505 FLAIR KNOLL CT NE, ATLANTA, GA 30345(404) 636-2332 Get Directions Write a Review

NPPES record last updated: April 14, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. W. Jefferson Pendergrast Jr. M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. W. JEFFERSON PENDERGRAST JR. M.D. (NPI 1376603894) is an individual specialist in Atlanta, Georgia, licensed in Georgia (015409) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1376603894
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. W. JEFFERSON PENDERGRAST JR.Credential: M.D.
Location Address2505 FLAIR KNOLL CT NEAtlanta, GA 30345-1311
Mailing Address2505 Flair Knoll Ct NeAtlanta, GA 30345-1311 · (404) 636-2332
Phone(404) 636-2332
Sole ProprietorYes
Enumeration DateDecember 12, 2006
Last NPPES UpdateApril 14, 2011
✔ NPI 1376603894 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in GA · 015409
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
2505 FLAIR KNOLL CT NE, Atlanta, GA 30345
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is W. Jefferson Pendergrast's NPI number?

The NPI number for W. Jefferson Pendergrast is 1376603894. It was assigned to this individual provider in the NPPES registry on December 12, 2006.

Where is W. Jefferson Pendergrast located?

W. Jefferson Pendergrast practices at 2505 Flair Knoll Ct NE, Atlanta, GA 30345. The listed phone number is (404) 636-2332.

What is W. Jefferson Pendergrast's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for W. Jefferson Pendergrast was last updated on April 14, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.