Active NPI 1902942352 Individual Practitioner Male Practitioner

Dr. Doug Pendergrass , DC

Chiropractor • Flora Vista, NM

Professional Overview & Biography Verified Profile Summary

Dr. Doug Pendergrass, DC is a registered healthcare professional specializing in Chiropractor in Flora Vista, NM. Practice services are available at 12 ROAD 3540 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

12 Road 3540

Flora Vista, NM 874159601

Telephone 5058600862

Fax 5058600862

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Flora Vista, NM

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 25.5 Yrs

Regional Practice Density

1 Specialists

Practicing in Flora Vista, NM (448 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License NM 1679

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Bcbs

8X8022 (TX)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active December 30, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location December 30, 2015

Registered at 12 ROAD 3540, FLORA VISTA, NM 874159601 (Tel: 5058600862)

📍

Updated Business Mailing Address December 30, 2015

Registered at 12 ROAD 3540, FLORA VISTA, NM 874159601 (Tel: 5058600862)

👤

Provider Name / Credentials Updated December 30, 2015

Recorded as DOUG PENDERGRASS, D.C.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) December 30, 2015

Chiropractor (License #1679 in NM)

🟢

Initial NPI Registration & Enumeration January 30, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1902942352

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: January 30, 2007

Last Update: December 30, 2015

Sole Proprietor: No

Update or Correct Profile

Mailing Address

12 Road 3540

Flora Vista, NM 874159601

Phone: 5058600862

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.