MRS. COURTNEY PAIGE PENDERGRAFT FNP
NPI 1790064384
Nurse Practitioner - Family in Kingsport, TN
About Mrs. Courtney Paige Pendergraft Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. COURTNEY PAIGE PENDERGRAFT FNP (NPI 1790064384) is an individual family provider in Kingsport, Tennessee, licensed in Virginia (0024169574) and active in the NPI registry since August 2011. She is enrolled in Medicare PECOS and is a graduate of Other (2011).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Courtney Paige Pendergraft Fnp 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.
Medicare Billing Reassignments
7Medicare enrollment records show Courtney Pendergraft reassigns Medicare billing to 7 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Johnson City, TN 37604
- Reassigned Medicare billing, Tennessee enrollment
- 67 clinicians in this Medicare group
Johnson City, TN 37604
- Reassigned Medicare billing, Tennessee enrollment
- 284 clinicians in this Medicare group
Norton, VA 24273
- Reassigned Medicare billing, Virginia enrollment
- 207 clinicians in this Medicare group
Mount Juliet, TN 37122
- Reassigned Medicare billing, Kentucky, Tennessee and Virginia enrollments
- 8 clinicians in this Medicare group
Charlottesville, VA 22911
- Reassigned Medicare billing, Virginia enrollment
- 2,820 clinicians in this Medicare group
Traverse City, MI 49686
- Reassigned Medicare billing, Virginia enrollment
- 19 clinicians in this Medicare group
- Reassigned Medicare billing, Kentucky and Tennessee enrollments
- 5 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 37660 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
KINGSPORT, TN 37660
KINGSPORT, TN 37660
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 Courtney Pendergraft's NPI number?
The NPI number for Courtney Pendergraft is 1790064384. It was assigned to this individual provider in the NPPES registry on August 12, 2011.
Where is Courtney Pendergraft located?
Courtney Pendergraft practices at 130 W Ravine Rd, Kingsport, TN 37660. The listed phone number is (423) 224-4000.
What is Courtney Pendergraft's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Courtney Pendergraft enrolled in Medicare?
Yes. Courtney Pendergraft 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.
Which organizations bill Medicare for Courtney Pendergraft's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Courtney Pendergraft reassigns Medicare benefits to 7 organizations: Tri-Cities Observation Services, PC (Johnson City, TN), Tri-Cities Regional Emergency Physicians, PC (Johnson City, TN), Western Virginia Regional Emergency Physicians, LLC (Norton, VA), Regional Healthcare Group LLC (Mount Juliet, TN), University Of Virginia Physicians Group (Charlottesville, VA) and 2 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Courtney Pendergraft's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Courtney Pendergraft accept?
Health plans from Oscar Health and Oscar Insurance Company list Courtney Pendergraft 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 Courtney Pendergraft was last updated on August 12, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Mrs. Courtney Paige Pendergraft, FNP · NPI 1790064384
Family physician in Kingsport, Tennessee. Individual provider, active in the CMS NPPES registry since August 12, 2011.
## Identity
- **NPI:** 1790064384 (Entity type: Individual)
- **Enumerated:** August 12, 2011
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 0024169574 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 130 W RAVINE RD, Kingsport, TN 37660-3837
- **Phone:** (423) 224-4000 · **Fax:** (423) 224-5120
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 7 organizations under Medicare reassignment (form CMS-855R): Tri-Cities Observation Services, PC (NPI 1154860146, Johnson City, TN); Tri-Cities Regional Emergency Physicians, PC (NPI 1063950046, Johnson City, TN); Western Virginia Regional Emergency Physicians, LLC (NPI 1386183028, Norton, VA); Regional Healthcare Group LLC (NPI 1407587363, Mount Juliet, TN); University Of Virginia Physicians Group (NPI 1033138250, Charlottesville, VA); and 2 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2011
## Record status
- **NPPES last updated:** August 12, 2011
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Source: [NPI Profile](https://npiprofile.com/npi/1790064384) · Data from the CMS NPPES public registry.