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DR. MARY K PENDERGRASS DO
NPI 1457616872
Family Medicine in West Plains, MO

Active since July 11, 2012PECOS EnrolledAccepts Medicare Assignment
181 N KENTUCKY AVE STE 100, WEST PLAINS, MO 65775(417) 257-5911 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Jul 6, 2017 (3 updates tracked since 2017).

About Dr. Mary K Pendergrass Do NPPES

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

DR. MARY K PENDERGRASS DO (NPI 1457616872) is an individual family medicine provider in West Plains, Missouri, licensed in Missouri (2014030982) and active in the NPI registry since July 2012. She is enrolled in Medicare PECOS, maintains a secondary practice location in Willow Springs, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1457616872
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. MARY K PENDERGRASSCredential: DO
Location Address181 N KENTUCKY AVE STE 100West Plains, MO 65775-2092
Mailing Address181 N Kentucky Ave Ste 100West Plains, MO 65775-2092 · (417) 257-5911
Phone(417) 257-5911
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateJuly 11, 2012
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1457616872 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MO · 2014030982
Definition
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.
181 N KENTUCKY AVE STE 100, West Plains, MO 65775
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Secondary Practice Location 1

Location 1816 E Main StWillow Springs, MO 65793-1518 · Phone (417) 269-2490

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cox HealthPlans, Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Mary K Pendergrass Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5193966406
PECOS Enrollment IDI20140929002487
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65775 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$93.24 typical visit price
range $16.30 – $131.05
Typical copayment $23.31 (range $4.07 – $32.76)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SAMUEL CHARLES EVANS M.D.
Family Medicine (Adult Medicine)
181 N KENTUCKY AVE STE 100
WEST PLAINS, MO 65775
Howell County (417) 257-5911
DR. RYAN NATHANIEL VAISLER M.D.
Family Medicine
181 N KENTUCKY AVE STE 100
WEST PLAINS, MO 65775
Howell County (174) 257-9111
MRS. SUZANNE R HUDDLESTON FNP-C
Nurse Practitioner
181 N KENTUCKY AVE STE 100
WEST PLAINS, MO 65775
Howell County (417) 257-5911
DR. LORI G MACPHERSON M.D.
Family Medicine
181 N KENTUCKY AVE STE 100
WEST PLAINS, MO 65775
Howell County (417) 257-5911

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 Mary Pendergrass's NPI number?

The NPI number for Mary Pendergrass is 1457616872. It was assigned to this individual provider in the NPPES registry on July 11, 2012.

Where is Mary Pendergrass located?

Mary Pendergrass practices at 181 N Kentucky Ave Ste 100, West Plains, MO 65775. The listed phone number is (417) 257-5911.

What is Mary Pendergrass's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Mary Pendergrass enrolled in Medicare?

Yes. Mary Pendergrass is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mary Pendergrass accept?

Health plans from Cox HealthPlans and Medica list Mary Pendergrass as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Pendergrass was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.