Courtney Pendergraft, FNP
Courtney Pendergraft, FNP is a Family Nurse Practitioner in Kingsport, TN, registered under NPI 1790064384.
Getting there
The practice address on file is 130 W RAVINE RD, Kingsport, TN 37660. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 0024169574 | VA | Family Nurse Practitioner primary |
This provider holds licence 0024169574 issued in VA. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Practitioner - Nurse Practitioner
- PAC ID
- 5496926511
Enrolled in Medicare 3 times, across 3 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| Tennessee | I20110922000021 | Practitioner - Nurse Practitioner |
| Virginia | I20111201000779 | Practitioner - Nurse Practitioner |
| Kentucky | I20230322001321 | Practitioner - Nurse Practitioner |
Medicare enrolment is recorded as approved under the provider type Practitioner - Nurse Practitioner. There are 3 separate enrolment records across 3 states (TN, VA, KY). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Family covers
Definition to come... NUCC Health Care Provider Taxonomy, code 363LF0000X
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1790064384 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Aug 12, 2011 |
| Last updated | Aug 12, 2011 |
| Status | Active |
| Sole proprietor | No |
| Credential | FNP |
| Practice address |
130 W RAVINE RD Kingsport, TN 37660 (423) 224-4000 Fax (423) 224-5120 |
| Mailing address |
PO BOX 11724 Knoxville, TN 37939 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 7 | 9 | 0 | 0 | 6 | 4 | 3 | 8 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 7 | 9 | 0 | 0 | 6 | 8 | 3 | 7 |
Sum = 66 · next multiple of 10 = 70 · check digit = 4 · actual last digit = 4
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.