MS. KATHY L PENDERGRAFT – Behavior Analyst, NPI 1083055933

MS. KATHY L PENDERGRAFT is a healthcare provider. based in Antlers, Oklahoma. specializing in MENTAL HEALTH COUNSELOR. The NPI Number for MS. KATHY L PENDERGRAFT is 1083055933

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
MS. KATHY L PENDERGRAFT
NPI
1083055933
Phone
(580) 298-3001
Address
PO BOX 309
Enumeration Date
8 July 2013
Last Update Date
27 January 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5803268605
Graduation Year
2014 (12 years ago)
PAC ID
1557714169
Group Practice PAC ID
4688943657
Professional Enrollment ID
I20240131001162
Address ID
OK745233824AN307XXSTXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:12State licenses:0Digital endpointsOther names

1,199 MENTAL HEALTH COUNSELOR in OK

Provider Addresses for MS. KATHY L PENDERGRAFT

  • PO BOX 309

    ANTLERS, OK 745230309

    Phone: (580) 298-3001

    Fax: (580) 298-5357

    Type: Mailing

  • 112 N HIGH ST

    ANTLERS, OK 745232250

    Phone: (580) 298-3001

    Fax: (580) 298-5357

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240131001162IMental Health CounselorOKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 74523)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688943657View full group profile
NameSpecialtyState
Mental Health CounselorOK
Mental Health CounselorOK
Mental Health CounselorOK
Mental Health CounselorOK
-OK
Mental Health CounselorOK
Mental Health CounselorOK
Mental Health CounselorOK
Mental Health CounselorOK
Mental Health CounselorOK

Reviews

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Frequently asked questions

How do I look up MS. KATHY L PENDERGRAFT by NPI?
Use NPI 1083055933 when you need to reference MS. KATHY L PENDERGRAFT in forms, claims, or directories.
Is MS. KATHY L PENDERGRAFT currently active in the NPI registry?
CMS-published data lists MS. KATHY L PENDERGRAFT as an active registrant.
Can you summarize MS. KATHY L PENDERGRAFT's specialty in plain language?
Clinically, the directory lists MS. KATHY L PENDERGRAFT with Behavior Analyst. Clinical services aligned with this taxonomy classification.
What location shows for MS. KATHY L PENDERGRAFT?
We surface Antlers, Oklahoma for MS. KATHY L PENDERGRAFT based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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