JOHN RITTER PENDERGRASS (NPI# 1720619893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720619893 |
| Entity Type | Individual |
| Full Name | JOHN RITTER PENDERGRASS |
| Practice Address |
440 S 500 E Salt Lake City UT 84102-2705 |
| Practice Telephone | 8013598862 |
| Enumeration Date | 2020-01-28 |
| Last Update Date | 2020-01-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891797825 | John Langan Pendergrass | Ophthalmology | 102 E Hospital Dr, Hattiesburg, MS 39402-1310 | 2005-08-10 |
| Street Address |
440 S 500 E |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84102-2705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912205824 | Jessica B. Jeffs | Counselor | 440 S 500 E, Salt Lake City, UT 84102 | 2011-03-02 |
| 1750998084 | Shasta Galyon | Peer Specialist | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-09-30 |
| 1538772280 | Theron Ulysses Williams | Case Manager/Care Coordinator | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-08-24 |
| 1316556806 | Sheanna Cronnelly | Case Manager/Care Coordinator | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-07-30 |
| 1700401767 | Jordan Clark Esteban | Social Worker | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-06-15 |
| 1548881097 | Daysha Alayne Clukey | Licensed Practical Nurse | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-05-06 |
| 1780216093 | David Scott Cummins | Social Worker | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2020-02-05 |
| 1881238608 | Alvilda Olivia Pacheco | Counselor | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2019-11-05 |
| 1881237121 | Elizabeth Crawford | Marriage & Family Therapist | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2019-10-18 |
| 1063067346 | Samuel Harry Van Rensburg | Nurse Practitioner | 440 S 500 E, Salt Lake City, UT 84102-2705 | 2019-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942818604 | Wendy Vazquez | Behavior Technician | 515 S 700 E Suit 2a, Salt Lake City, UT 84102 | 2020-07-20 |
| 1407481245 | Odyssey House Inc | Family Medicine | 743 E 300 S, Salt Lake City, UT 84102 | 2020-03-11 |
| 1093359960 | Hayle Mayer | Behavior Technician | 515 S 700 E Salt Lake City, Suite 2a, Salt Lake, UT 84102 | 2019-11-04 |
| 1326680869 | Ronald Mcdonald House of The Intermountain Area | Meals | 935 E. South Temple, Salt Lake City, UT 84102 | 2019-10-16 |
| 1508419581 | Claire Pemberton | Behavior Technician | 327 E 1300 S, Apt 2, Salt Lake City, UT 84102 | 2019-07-19 |
| 1558923144 | Olivia Anne Hardwick | Social Worker | Transitions At Slrmc, 86 S. 1100 E. Suite 404, Salt Lake City, UT 84102 | 2019-07-03 |
| 1649741802 | Colten Vancampen | Behavior Technician | 515 S 700 E #2a, Salt Lake City, UT 84102 | 2018-12-16 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1104311661 | Malorey Kooyman | Behavior Technician | 515 700 East, Suite 2a, Salt Lake City, UT 84102 | 2018-06-27 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| Find all providers in zip 84102 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689281818 | Devery White | Case Manager/Care Coordinator | 195 N 1900 W, Salt Lake City, UT 84116 | 2020-10-01 |
| 1326652116 | Brenna Colleen Ball | Case Manager/Care Coordinator | 671 N Oakley St, Salt Lake City, UT 84116-3833 | 2020-08-31 |
| 1437761368 | Tonia Price | Case Manager/Care Coordinator | 625 S 200 E, Salt Lake City, UT 84111-3801 | 2020-08-21 |
| 1386264802 | Mckensee M Carter | Case Manager/Care Coordinator | 334 E 100 S, Salt Lake City, UT 84111 | 2020-04-24 |
| 1619502374 | Bradford Nielson | Case Manager/Care Coordinator | 344 E 100 S # B, Salt Lake City, UT 84111-1700 | 2020-03-03 |
| 1225662521 | Rob Lequia | Case Manager/Care Coordinator | 344 E 100 S # 344e100s, Salt Lake City, UT 84111-1700 | 2020-02-25 |
| 1154970507 | Lori Cerar | Case Manager/Care Coordinator | 230 W 200 S Ste 142, Salt Lake City, UT 84101-1337 | 2019-09-09 |
| 1457907776 | Christina Lee Oppenheimer | Case Manager/Care Coordinator | 230 W 200 S # 142, Salt Lake City, UT 84101-1337 | 2019-08-13 |
| 1184196230 | Roselia Yanella Chavez | Case Manager/Care Coordinator | 1233 W 700 S, Salt Lake City, UT 84104-2657 | 2018-12-28 |
| 1588149132 | Madeleine Smith | Case Manager/Care Coordinator | 344 E 1st S, Salt Lake City, UT 84111-1700 | 2018-09-29 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84102 |
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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.