MALLORY MILLER PENDERGRASS AG-ACNP
NPI 1629475348
Nurse Practitioner - Acute Care in Jackson, TN

NPI Status: Active since November 24, 2014

Contact Information

620 SKYLINE DR
JACKSON, TN
ZIP 38301
Phone: (731) 541-6900

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  • Individual
  • Female
  • Nurse Practitioner
  • Acute Care
  • PECOS Enrolled

About MALLORY PENDERGRASS

This page provides the complete NPI Profile along with additional information for Mallory Pendergrass, a provider established in Jackson, Tennessee with a medical specialization in Nurse Practitioner, focusing in acute care . The healthcare provider is registered in the NPI registry with number 1629475348 assigned on November 2014. The practitioner's primary taxonomy code is 363LA2100X with license number 19221 (TN). The provider is registered as an individual and her NPI record was last updated one year ago.

NPI
1629475348
Provider Name
MALLORY MILLER PENDERGRASS AG-ACNP
Gender
Female
Entity Type
Individual
Location Address
620 SKYLINE DR JACKSON, TN 38301
Location Phone
(731) 541-6900
Mailing Address
620 SKYLINE DR JACKSON, TN 38301
Mailing Phone
(731) 541-0249
Is Sole Proprietor?
No
Enumeration Date
11-24-2014
Last Update Date
07-21-2025
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A nurse practitioner (NP) like Mallory Pendergrass is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner Acute Care

Taxonomy Code
363LA2100X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
19221
License State
TN

Medicare Participation & PECOS Enrollment Status

Mallory Pendergrass is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Critical care, first 30-74 minutes

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

This service was performed 130 times for 71 patients

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 68 times for 58 patients

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 62 times for 33 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 29 times for 28 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 38301 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $81.53
  • Minimum New Patient Price $52.64
  • Maximum New Patient Price $160.89
  • Average New Patient Copayment $20.38
  • Minimum New Patient Copayment $13.16
  • Maximum New Patient Copayment $40.22

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $93.6
  • Minimum Established Patient Price $16.72
  • Maximum Established Patient Price $131.41
  • Average Established Patient Copayment $23.4
  • Minimum Established Patient Copayment $4.18
  • Maximum Established Patient Copayment $32.85

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1629475348, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
2
Doubled → 4
Pos 4
9
Unchanged
Pos 5
4
Doubled → 8
Pos 6
7
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
3
Unchanged
Pos 9
4
Doubled → 8
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 4 → 8 5 → 10 → 1 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 4 + 9 + 8 + 7 + 1 + 0 + 3 + 8 + 24 = 72

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 72 is 80. The difference is the calculated check digit.

80 - 72 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1629475348.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Nurse Anesthetist, Certified Registered
620 SKYLINE DR
JACKSON, TN 38301
Obstetrics & Gynecology (Maternal & Fetal Medicine)
620 SKYLINE DR, MID-SOUTH PERINATAL ASSOCIATES
JACKSON, TN 38301
Nurse Anesthetist, Certified Registered
620 SKYLINE DR
JACKSON, TN 38301
Internal Medicine (Infectious Disease)
620 SKYLINE DR
JACKSON, TN 38301
Internal Medicine (Infectious Disease)
620 SKYLINE DR
JACKSON, TN 38301
Radiology (Radiation Oncology)
620 SKYLINE DR, RADIATION ONCOLOGY DEPT
JACKSON, TN 38301
Emergency Medicine
620 SKYLINE DR
JACKSON, TN 38301
Nurse Anesthetist, Certified Registered
620 SKYLINE DR
JACKSON, TN 38301
Nurse Anesthetist, Certified Registered
620 SKYLINE DR
JACKSON, TN 38301
Nurse Anesthetist, Certified Registered
620 SKYLINE DR
JACKSON, TN 38301
Nurse Anesthetist, Certified Registered
620 SKYLINE DR
JACKSON, TN 38301
Community Health Worker
620 SKYLINE DR
JACKSON, TN 38301
Dietitian, Registered
620 SKYLINE DR
JACKSON, TN 38301
Dietitian, Registered
620 SKYLINE DR
JACKSON, TN 38301
Dietitian, Registered
620 SKYLINE DR
JACKSON, TN 38301
Dietitian, Registered
620 SKYLINE DR
JACKSON, TN 38301
Dietitian, Registered
620 SKYLINE DR
JACKSON, TN 38301
Dietitian, Registered
620 SKYLINE DR
JACKSON, TN 38301
Nurse Practitioner (Family)
620 SKYLINE DR
JACKSON, TN 38301
Nurse Anesthetist, Certified Registered
620 SKYLINE DR
JACKSON, TN 38301

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1629475348, enumerated as an "individual" on November 24, 2014.

The provider is located at 620 SKYLINE DR JACKSON, TN 38301 and the phone number is (731) 541-6900.

Nurse Practitioner with taxonomy code 363LA2100X and a focus in Acute Care.