DR. GARLAND EDWARD PENDERGRAPH (NPI# 1851917553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851917553 |
| Entity Type | Individual |
| Full Name | DR. GARLAND EDWARD PENDERGRAPH |
| Credential | PHD, JD |
| Practice Address |
1974 Old Valdosta Rd Ray City GA 31645-7139 |
| Practice Telephone | 2296867545 |
| Mailing Telephone | 2296867545 |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2020-06-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247ZC0005X |
Pathology Specialization: Clinical Laboratory Director, Non-physician |
80520 | GA | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
1974 OLD VALDOSTA RD |
| City | RAY CITY |
| State | GA |
| Zip Code | 31645-7139 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861027930 | Deborah A Mceady | Contractor | 71 Thigpen Circle, Ray City, GA 31645 | 2020-03-09 |
| 1699299842 | Integrated Telehealth LLC | Internal Medicine | 1523 Old Valdosta Rd Ste B, Ray City, GA 31645 | 2017-07-31 |
| 1548604630 | Ashley Renee Michaels | Behavioral Analyst | 6 W Stanley Rd Ext, Ray City, GA 31645 | 2013-04-19 |
| 1972047140 | Billy Jacobs Jr. | Contractor | 40 Street D, Ray City, GA 31645-2071 | 2016-12-07 |
| 1356828925 | Southern Nutrition and Wellness | Dietitian, Registered | 6073 Luke Rd, Ray City, GA 31645-2119 | 2018-07-25 |
| 1710462114 | Lindsey L Jordan | Dietitian, Registered | 6073 Luke Rd, Ray City, GA 31645-2119 | 2018-10-02 |
| 1619452018 | Kati Wise | Dietitian, Registered | 6073 Luke Rd, Ray City, GA 31645-2119 | 2018-10-02 |
| 1336635507 | Lacee Nicole Jessup | Contractor | 215 Zeigler Rd, Ray City, GA 31645-6627 | 2018-07-10 |
| 1629313267 | Joyce Ann Deberry | Social Worker | 178 Highway 125, Ray City, GA 31645-7535 | 2012-12-08 |
| 1073859294 | Miranda Moneke Robinson | Social Worker | 95 Oak St, Ray City, GA 31645-8437 | 2012-12-15 |
| Find all providers in zip 31645 | ||||
| Taxonomy Code | 247ZC0005X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Pathology |
| Specialization | Clinical Laboratory Director, Non-physician |
| An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405. |
| Notes: Source: National Uniform Claim Committee [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952916231 | Chadrika L Johnson | Pathology | 1800 Albany St, Brunswick, GA 31520-5901 | 2020-09-13 |
| 1982258315 | Vision Consulting Partners, LLC | Pathology | 5526 Old National Hwy Ste C, College Park, GA 30349-3212 | 2019-07-24 |
| 1538578893 | Lisa Lee | Pathology | 102 Jessica Ct, Byron, GA 31008-3932 | 2014-08-11 |
| 1760657894 | Ross Joseph Molinaro | Pathology | 550 Peachtree St Room 1239, Emory Crawford Long Hospital, Atlanta, GA 30308 | 2008-04-29 |
| 1346851417 | Tatiana Tvrdik | Pathology | 1364 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2020-08-12 |
| 1629340526 | Michael R. Rossi | Pathology | Emory University Hospital, Department of Pathology, Room H185, Atlanta, GA 30322-0001 | 2012-02-08 |
Please comment or provide details below to improve the information on DR. GARLAND EDWARD PENDERGRAPH.
| 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.