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Active NPI 1629475348 Individual Practitioner Female Practitioner

Mallory Miller Pendergrass , AG-ACNP

Nurse Practitioner - Acute Care • Jackson, TN

Professional Overview & Biography Verified Profile Summary

Mallory Pendergrass, AG-ACNP is a registered healthcare professional specializing in Nurse Practitioner - Acute Care in Jackson, TN. Practice services are available at 620 SKYLINE DR under active NPI credentials.

Frequently performed procedures and clinical services include critical care, first, initial hospital care with moderate level of medical decision making, if using time, at least, subsequent hospital care with moderate levelof medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

620 Skyline Dr

Jackson, TN 383013923

Telephone 7315416900
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Acute Care in Jackson, TN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 6.6 Yrs
State Avg: 11.0 Yrs
Regional Practice Density
12 Specialists

Practicing in Jackson, TN (1079 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
84.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99291 Critical care, first 30-74 minutes
66 47 $992.00 $163.29
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes
22 22 $992.00 $135.50

Medical Specialties & State Licenses

CMS Verified: 2025-07-21
Nurse Practitioner - Acute Care Primary Specialty

NUCC Taxonomy Code: 363LA2100X

State License TN 19221

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Courtney Brush , APRN, FNP

Nurse Practitioner - Family

NPI 1033677067

Advanced Practice Registered Nurse, Family Nurse Practitioner

Career & Practice History Timeline

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

9 Historical Events
📍
Updated Business Mailing Address July 21, 2025

Registered at 620 SKYLINE DR, JACKSON, TN 383013923 (Tel: 7315410249)

👤
Provider Name / Credentials Updated July 21, 2025

Recorded as MALLORY PENDERGRASS, AG-ACNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 21, 2025

Nurse Practitioner (License #19221 in TN)

NPI Profile Active June 20, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location June 20, 2015

Registered at 620 SKYLINE DR, JACKSON, TN 383013923 (Tel: 7315416900)

📍
Updated Business Mailing Address June 20, 2015

Registered at 416 E LAFAYETTE ST, UNIT 304, JACKSON, TN 383016353 (Tel: 6158668044)

👤
Provider Name / Credentials Updated June 20, 2015

Recorded as MALLORY MILLER, AG-ACNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 20, 2015

General Acute Care Hospital (License #19221 in TN)

🟢
Initial NPI Registration & Enumeration November 24, 2014

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: 1629475348
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 24, 2014
Last Update: July 21, 2025
Sole Proprietor: No

Mailing Address

620 Skyline Dr

Jackson, TN 383013923

Phone: 7315410249

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.