Shelly Pendergrass, PA-C is a
Physician Assistant - Medical based in Donaldsonville, Louisiana. Shelly Pendergrass is licensed to practice in Louisiana (license number 200820) and her current practice location is
217 Railroad Ave, Donaldsonville, Louisiana. She can be reached at her office (for appointments etc.) via phone at
(225) 473-3931.
NPI number for Shelly Pendergrass is 1417338724 and her current mailing address is 17075 Fox Ridge Dr, Prairieville, Louisiana. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1417338724.
Provider's Profile
| Full Name | Shelly Pendergrass |
|---|
| Gender | Female |
|---|
| Speciality | Physician Assistant - Medical |
|---|
| Location | 217 Railroad Ave, Donaldsonville, Louisiana |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1417338724
- Provider Enumeration Date: 06/11/2015
- Last Update Date: 06/12/2015
Medical Identifiers
Medical identifiers for Shelly Pendergrass such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1417338724 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363AM0700X | Physician Assistant - Medical | 200820 (Louisiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shelly Pendergrass is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Shelly Pendergrass, PA-C 17075 Fox Ridge Dr, Prairieville, LA 70769-4834 Ph: (225) 235-6696 | Shelly Pendergrass, PA-C 217 Railroad Ave, Donaldsonville, LA 70346-2527 Ph: (225) 473-3931 |
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