Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DESIREE CADELL PENDERGRASS NP
NPI 1811430309
Nurse Practitioner - Family in Crossville, TN

Q: What is Desiree Pendergrass's NPI number?

The NPI number for Desiree Pendergrass is 1811430309. It was assigned to this individual provider in the NPPES registry on December 1, 2016. The provider is also known as Desiree Cadell Brock-Hudson.

Q: What is Desiree Pendergrass's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since December 01, 2016PECOS Enrolled

665 N MAIN ST, CROSSVILLE, TN 38555(931) 337-0510 Get Directions Write a Review

NPPES record last updated: August 22, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Aug 22, 2026, Sep 1, 2022, May 29, 2019 (3 updates tracked since 2019).

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About Desiree Cadell Pendergrass Np NPPES

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

DESIREE CADELL PENDERGRASS NP (NPI 1811430309) is an individual family provider in Crossville, Tennessee, licensed in Tennessee (21997) and active in the NPI registry since December 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1811430309

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameDESIREE CADELL PENDERGRASSCredential: NP

Location Address665 N MAIN STCrossville, TN 38555-6206

Mailing Address665 N Main StCrossville, TN 38555-6206 · (931) 337-0510

Phone(931) 337-0510

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateDecember 1, 2016

Last NPPES UpdateAugust 22, 20263 updates tracked since enumeration

NPPES CertifiedAugust 22, 2026

✔ NPI 1811430309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in TN · 21997

665 N MAIN ST, Crossville, TN 38555

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Other Names 1

Former Name (1)Desiree Cadell Brock-hudson

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Magnolia Health and more.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

Desiree Cadell Pendergrass Np 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 ID7517241292

PECOS Enrollment IDI20170223002002

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 38555 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$109.33 avg. paid by Medicare

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

DME-Drugs Administered Through DME · category DG006N

1 supplier12 claims3,600 services$0.04 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

1 supplier12 claims12 services$26.09 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

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

KYLE JEFFREY CHARNLEY NP

Nurse Practitioner (Family)