KELLY B. PENDERGRASS M.D.
NPI 1639140221
Internal Medicine - Hematology & Oncology in Lees Summit, MO

Active since January 31, 2006
4881 NE GOODVIEW CIR, LEES SUMMIT, MO 64064(913) 574-2350(913) 574-2413 Get Directions Write a Review

NPPES record last updated: April 17, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 17, 2018, Jun 23, 2016 (2 updates tracked since 2016).

About Kelly B. Pendergrass M.d. NPPES

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

KELLY B. PENDERGRASS M.D. (NPI 1639140221) is an individual hematology & oncology provider in Lees Summit, Missouri, licensed in Missouri (R6A95) and active in the NPI registry since January 2006.

NPPES Registry Identity

NPI1639140221
Entity TypeIndividualMale
Primary Taxonomy207RH0003X
Provider Legal NameKELLY B. PENDERGRASSCredential: M.D.
Location Address4881 NE GOODVIEW CIRLees Summit, MO 64064-1996
Mailing Address9200 Indian Creek Pkwy, Building 9, Suite 300Overland Park, KS 66210-2002 · (913) 574-2800 · Fax (913) 574-2336
Fax(913) 574-2413
Sole ProprietorNo
Enumeration DateJanuary 31, 2006
Last NPPES UpdateApril 17, 20182 updates tracked since enumeration
NPI 1639140221 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
Licenses Licensed in MO · R6A95 Licensed in KS · 04-25043
Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

4881 NE GOODVIEW CIR, Lees Summit, MO 64064

Other Identifiers 2

Medicaid100364750BKS
Medicaid1639140221MO

Other Providers at the Same Location NPPES 15

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

Pharmacy (Clinic Pharmacy)
4881 NE GOODVIEW CIR
LEES SUMMIT, MO 64064
Radiology (Radiation Oncology)
4881 NE GOODVIEW CIR
LEES SUMMIT, MO 64064
Clinical Medical Laboratory
4881 NE GOODVIEW CIR
LEES SUMMIT, MO 64064
Nurse Practitioner (Family)
4881 NE GOODVIEW CIR
LEES SUMMIT, MO 64064
Internal Medicine (Hematology & Oncology)
4881 NE GOODVIEW CIR
LEES SUMMIT, MO 64064
Internal Medicine (Hematology & Oncology)
4881 NE GOODVIEW CIR
LEES SUMMIT, MO 64064
Pharmacy (Community/Retail Pharmacy)
4881 NE GOODVIEW CIR
LEES SUMMIT, MO 64064
Nurse Practitioner (Family)
4881 NE GOODVIEW CIR
LEES SUMMIT, MO 64064

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 Kelly Pendergrass's NPI number?

The NPI number for Kelly Pendergrass is 1639140221. It was assigned to this individual provider in the NPPES registry on January 31, 2006.

Where is Kelly Pendergrass located?

Kelly Pendergrass practices at 4881 NE Goodview Cir, Lees Summit, MO 64064. The listed phone number is (913) 574-2350.

What is Kelly Pendergrass's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

When was this NPI record last updated?

The NPPES record for Kelly Pendergrass was last updated on April 17, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.