Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Derek Paul Pendarvis, MD

Surgery Physician in Gainesville, GA · enumerated 2006.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1104806108

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Registry record

Entity type Individual (Type 1)

Name Derek Paul Pendarvis

Credential MD

Sex Male

Practice address 725 Jesse Jewell Pkwy Se, Gainesville, GA, 30501

Phone (770) 536-2323

Fax (770) 536-4947

Enumeration date Jan 18, 2006

Last updated in NPPES May 22, 2024

Taxonomy & licenses

208600000X Surgery Physician Allopathic & Osteopathic Physicians · License 049933 (GA) Primary

MD · Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential

Other identifiers

Identifier	Type	State	Issuer
1700231	Other	GA	UNITED HEALTHCARE
000904274A	Medicaid	GA	-
10045029	Other	GA	AMERIGROUP
52843776	Other	GA	BCBS
000904274B	Medicaid	GA	-
341106	Other	GA	WELLCARE
7816063	Other	GA	CIGNA
20050660	Other	GA	RR MEDICARE-GRP # CC4177

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is the NPI number for Derek Pendarvis?

The National Provider Identifier (NPI) for Derek Pendarvis is 1104806108, a Type 1 (individual) record in the CMS NPPES registry.

Where does Derek Pendarvis practice?

The practice location on file with NPPES is in Gainesville, GA. Providers can have multiple locations; NPPES lists the primary practice address.

Other providers at this practice address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-05-22.