TIMOTHY LEE PENDERGRASS (NPI# 1588651020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588651020 |
| Entity Type | Individual |
| Full Name | TIMOTHY LEE PENDERGRASS |
| Credential | MD |
| Practice Address |
300 Tuskegee Blvd 436 Mdg Cc Ste 1b22 Dover Afb DE 19902-5300 |
| Practice Telephone | 3026772525 |
| Practice Fax Number | 3026772526 |
| Mailing Telephone | 3026772525 |
| Mailing Fax Number | 3026772526 |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2008-01-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
5757 | ND | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215927454 | Timothy Pendergrass | Physical Therapist | Bldg 0-1900, Lamont Road, Ft Bragg, NC 23807 | 2005-10-27 |
| 1952423766 | Timothy J Pendergrass | Physical Therapist | 4214 98th St, Lubbock, TX 79423-3957 | 2007-04-04 |
| Street Address |
300 TUSKEGEE BLVD 436 MDG CC STE 1B22 |
| City | DOVER AFB |
| State | DE |
| Zip Code | 19902-5300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376536813 | Phillip Warren Petterborg | Optometrist | 300 Tuskegee Blvd, Dover Afb, DE 19902-5300 | 2005-08-30 |
| 1578181442 | Jessica Rumsley | Military Health Care Provider | 300 Tuskegee Blvd, Dover Afb, DE 19902-5003 | 2020-07-08 |
| 1386125052 | Thomas Brown | Physician Assistant | 300 Tuskegee Blvd, Dover Afb, DE 19902-5003 | 2018-08-22 |
| 1871084772 | Catoya Hale | Nurse Practitioner | 300 Tuskegee Blvd, Dover Afb, DE 19902-5003 | 2018-05-25 |
| 1104350024 | Bichle Thi Nguyen | Preventive Medicine | 300 Tuskegee Blvd, Dover Afb, DE 19902-5003 | 2017-04-18 |
| 1427582659 | Adnan Mehboob | Family Medicine | 300 Tuskegee Blvd, Dover Afb, DE 19902-5003 | 2017-04-14 |
| 1003350109 | Stephen Scott Grabner II | Student in an Organized Health Care Education/Training Program | 300 Tuskegee Blvd, Dover Afb, DE 19902-5003 | 2016-12-07 |
| 1134588973 | Andrew Kung | Pediatrics | 300 Tuskegee Blvd, Dover Afb, DE 19902-5003 | 2016-02-22 |
| 1619357753 | Marisa Romeo | Dentist | 300 Tuskegee Blvd, Bldg 304, Dover Afb, DE 19902-5300 | 2015-06-03 |
| 1811301112 | Lynne Werth | Family Medicine | 300 Tuskegee Blvd, Dover Afb, DE 19902-5003 | 2014-06-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316434632 | Leanne Mccarron | Dentist | Dover Afb, 436 Omrs/sgpd, Apo, AA 19902 | 2018-04-23 |
| 1568892446 | Ami Campbell | Veterinarian | 643 Atlantic Ave, Dover, DE 19902 | 2013-11-14 |
| 1609135045 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | Bldg. 266, Arnold Drive, Dover Afb, DE 19902 | 2012-05-04 |
| 1700080363 | Dori Mitchell Franco | Pathology | 115 Purple Heart Ave, Dover Afb, DE 19902 | 2007-06-14 |
| 1235384926 | Terri Lynn Turchan | Social Worker | 300 Tuskegee, Dover Airforce Base, Dover, DE 19902-2849 | 2008-11-21 |
| 1982129300 | Catherine Tien | Dentist | 300 Tuskegee Blvd Bldg 304, Dover Afb, DE 19902-5003 | 2017-08-07 |
| 1679905889 | Jeremiah Goldberg | Social Worker | 300 Tuskegee Blvd Bldg 300, Dover Afb, DE 19902-5003 | 2013-07-30 |
| 1467852871 | Geoffrey Borro | Dietitian, Registered | 300 Tuskegee Blvd Bldg 300, Dover Air Force Base, DE 19902-5003 | 2014-09-04 |
| 1144635350 | Fahad Pervez | Family Medicine | 300 Tuskegee Blvd Bldg 300, Dover Afb, DE 19902-5003 | 2014-06-25 |
| 1215039086 | Alice Jean Briones | Pathology | 115 Purple Heart Ave, Dover Afb, DE 19902-5051 | 2006-09-02 |
| Find all providers in zip 19902 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497818546 | Joseph R. Beard Iv | Radiology | 300 Tuskegee Blvd, Dover Afb, DE 19902-5003 | 2006-12-19 |
| 1598755084 | Geoffrey Wallace Crawley | Radiology | 300 Tuskegee Blvd, Dover Afb, DE 19902-5003 | 2005-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255997219 | Regent Open Mri LLC | Radiology | 1350 Middleford Rd Ste 503, Seaford, DE 19973-3664 | 2019-05-15 |
| 1740706175 | Delaware Radiology Associates Pa | Radiology | 6 Omega Dr Bldg L, Newark, DE 19713-2056 | 2017-08-17 |
| 1760738710 | Anush Parikh Md Pa | Radiology | 115 Dodge Dr, Smyrna, DE 19977-1880 | 2012-07-27 |
| 1871865956 | Telerad of De Account Managment, LLC | Radiology | 340 S. Madison St #706, Wilmington, DE 19801-0000 | 2012-02-03 |
| 1376828061 | Bear Mri & Imaging Center, LLC | Radiology | 101 Becks Woods Drive, Bear, DE 19701 | 2011-10-13 |
| 1649593369 | Rosalind H Troupin | Radiology | 73 Gainsborough Dr, Lewes, DE 19958-9424 | 2010-03-09 |
| 1467789164 | Edward Joel Goldstein | Radiology | 8 Lexington Drive, Milford, DE 19963-2113 | 2009-11-17 |
| 1023247061 | Kimberly Ruth Gardner | Radiology | 17503 Nassau Commons Blvd, Lewes, DE 19958-6283 | 2009-07-13 |
| 1306073341 | Cyril Milunsky | Radiology | 607 Haverhill Rd, Wilmington, DE 19803-2402 | 2009-06-17 |
| 1215170972 | Niloy Dasgupta | Radiology | 723 Brandywine Dr, Bear, DE 19701-1274 | 2009-04-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.