Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jared Allen Pendergrass, PA-C

Individual provider Physician Assistant · NPI 1780282863

Jared Allen Pendergrass, PA-C is a Physician Assistant in Aurora, Missouri. Licensed in Missouri. Registered with an NPI since 2020.

Licensed in
MO
In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

500 Porter Ave
Aurora, MO 65605-2365
Phone: (417) 678-7888
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2020009814 (MO)

Record details

NPI number1780282863
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 12, 2020
Last updated in NPPESOctober 27, 2020
Certification dateOctober 27, 2020

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