MR. BRIAN TRAVIS PENDARVIS (ARNP) – Family Nurse Practitioner, NPI 1417952904

MR. BRIAN TRAVIS PENDARVIS (ARNP) is a healthcare provider. based in Noble, Oklahoma. specializing in NURSE PRACTITIONER. They hold the professional credentials ARNP. They hold a License No. R0067224 (OK). The NPI Number for MR. BRIAN TRAVIS PENDARVIS (ARNP) is 1417952904

Main info

Male
Sole Proprietor
22 Years Of Experience
Accepts Medicare Assignment
Name
MR. BRIAN TRAVIS PENDARVIS (ARNP)
NPI
1417952904
Phone
(405) 872-5403
Address
205 SOUTH MAIN STREET
Enumeration Date
20 June 2005
Last Update Date
30 January 2014

Doctor Profile

Medical School Name
UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Secondary Phone
4058725403
Graduation Year
2004 (22 years ago)
PAC ID
9032162854
Group Practice PAC ID
3476569435
Professional Enrollment ID
I20050222000150
Address ID
OK730689623NO205XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,328 NURSE PRACTITIONER in OK

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Provider Addresses for MR. BRIAN TRAVIS PENDARVIS (ARNP)

  • 205, South Main Street, Summerfield, Noble County, Ohio, 43788, United States

    PO BOX 2096

    NOBLE, OK 73068

    Phone: (405) 872-5403

    Fax: (405) 872-5407

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $96.

Total Amount is formed as General ($96) + Research ($0) + Ownership ($0) = $96.

Last reported payment date: 2024-11-04 • Largest payer in this snapshot: Supernus Pharmaceuticals, Inc. ($28).

Total Amount

$96

General + Research + Ownership

Payments

5

Total payment records

General Amount

$96

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-04

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2005-02-22

PECOS data refreshed: 2026-06-15

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
I20050222000150INurse PractitionerOKTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes255114$0
View full utilization report →

Insurance plans in this area (ZIP 73068)

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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: 3476569435View full group profile
NameSpecialtyState
Internal MedicineOK

Reviews

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Frequently asked questions

Where can patients find MR. BRIAN TRAVIS PENDARVIS (ARNP)'s NPI?
You can confirm MR. BRIAN TRAVIS PENDARVIS (ARNP) with NPI 1417952904; it appears in the national provider directory.
Is MR. BRIAN TRAVIS PENDARVIS (ARNP)'s NPI currently valid?
The extract we use shows MR. BRIAN TRAVIS PENDARVIS (ARNP) as active.
What does MR. BRIAN TRAVIS PENDARVIS (ARNP) treat or focus on?
Patients typically see MR. BRIAN TRAVIS PENDARVIS (ARNP) under the specialty Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location shows for MR. BRIAN TRAVIS PENDARVIS (ARNP)?
We surface Noble, Oklahoma for MR. BRIAN TRAVIS PENDARVIS (ARNP) based on available NPPES addresses.
Is MR. BRIAN TRAVIS PENDARVIS (ARNP) a real provider?
This page reflects official NPPES data for NPI 1417952904. Always confirm identity and privileges with the practice and licensing boards.

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