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Deactivated NPI 1255856019 Deactivated / Inactive NPI Male Practitioner

Cornell Pendletom

Driver • Spotsylvania, VA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Cornell Pendletom has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 13, 2017
NPI Deactivation Date May 28, 2026
Total Practice Duration ~9 Years of Practice (2017 – 2026)

Professional Overview & Biography Verified Profile Summary

Cornell Pendletom was a registered Driver practicing in Spotsylvania, VA. Throughout an active medical career spanning 9 years, Cornell Pendletom provided care at the practice location at 6455 HICKORY RIDGE RD until profile deactivation on 2026-05-28.

Practice Location & Contact Primary Location

Practice Address

6455 Hickory Ridge Rd

Spotsylvania, VA 225512456

Telephone 5403797204

Specialty Benchmarks & Practice Insights

Comparative analytics for Driver in Spotsylvania, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
4 Specialists

Practicing in Spotsylvania, VA (655 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

Driver Primary Specialty

NUCC Taxonomy Code: 172A00000X

State License VA T63451175

A person employed to operate a motor vehicle as a carrier of persons or property.

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated May 28, 2026

Record deactivated on May 28, 2026

NPI Profile Active August 13, 2017

NPI status registered as active in NPPES database

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Updated Practice Location August 13, 2017

Registered at 6455 HICKORY RIDGE RD, SPOTSYLVANIA, VA 225512456 (Tel: 5403797204)

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Updated Business Mailing Address August 13, 2017

Registered at 6455 HICKORY RIDGE RD, SPOTSYLVANIA, VA 225512456

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Provider Name / Credentials Updated August 13, 2017

Recorded as CORNELL PENDLETOM

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 13, 2017

Driver (License #T63451175 in VA)

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Initial NPI Registration & Enumeration August 13, 2017

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: 1255856019
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 13, 2017
Last Update: August 13, 2017
Deactivation Date: May 28, 2026

Mailing Address

6455 Hickory Ridge Rd

Spotsylvania, VA 225512456

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.