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MR. COREY MARK PENDERGRAFT M.D.
NPI 1528857372
Student in an Organized Health Care Education/Training Program in Pullman, WA

Active since May 06, 2025PECOS Enrolled
WSU FAMILY MEDICINE RESIDENCY CENTER, 825 SE BISHOP BLVD STE 401, PULLMAN, WA 99163(509) 336-7720 Get Directions Write a Review

NPPES record last updated: February 2, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Feb 2, 2026, Jan 12, 2026, May 6, 2025 (3 updates tracked since 2025).

About Mr. Corey Mark Pendergraft M.d. NPPES

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

MR. COREY MARK PENDERGRAFT M.D. (NPI 1528857372) is an individual student in an organized health care education/training program in Pullman, Washington and active in the NPI registry since May 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1528857372
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMR. COREY MARK PENDERGRAFTCredential: M.D.
Location AddressWSU FAMILY MEDICINE RESIDENCY CENTER, 825 SE BISHOP BLVD STE 401Pullman, WA 99163
Mailing Address825 Se Bishop Blvd Ste 401Pullman, WA 99163-5517 · (509) 336-7720
Phone(509) 336-7720
Sole ProprietorYes
Enumeration DateMay 6, 2025
Last NPPES UpdateFebruary 2, 20263 updates tracked since enumeration
NPPES CertifiedFebruary 2, 2026
✔ NPI 1528857372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedFamily MedicineTaxonomy 207Q00000X · License ML61690777 (WA)
WSU FAMILY MEDICINE RESIDENCY CENTER, Pullman, WA 99163
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Corey Mark Pendergraft M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES

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

MRS. KELSEY MADER M.D.
Student in an Organized Health Care Education/Training Program
WSU FAMILY MEDICINE RESIDENCY CENTER, 825 SE BISHOP BLVD STE 401
PULLMAN, WA 99163
Whitman County (509) 336-7720

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 Corey Pendergraft's NPI number?

The NPI number for Corey Pendergraft is 1528857372. It was assigned to this individual provider in the NPPES registry on May 6, 2025.

Where is Corey Pendergraft located?

Corey Pendergraft practices at Wsu Family Medicine Residency Center 825 SE Bishop Blvd Ste 401, Pullman, WA 99163. The listed phone number is (509) 336-7720.

What is Corey Pendergraft's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Corey Pendergraft enrolled in Medicare?

Yes. Corey Pendergraft is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Corey Pendergraft was last updated on February 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.