NPIMap

Individual provider Active NPI

William Bonlore Ferguson, PHD, MD

  • Nephrology Physician
  • Palm Coast, FL
National Provider Identifier
1003842071
Registry record updated Feb 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME94793 Issued in FL
Practice address
61 Memorial Medical Pkwy
Suite 3806
Palm Coast, FL 32164-5981
Phone
(386) 437-7340
Fax
(386) 437-7341
NPI assigned
Jun 23, 2006
Last updated
Feb 19, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME94793 FL Primary

Addresses

Primary practice location

61 Memorial Medical Pkwy
Suite 3806
Palm Coast, FL 32164-5981

Mailing address

61 Memorial Medical Pkwy
Suite 3806
Palm Coast, FL 32164-5981
Phone (386) 437-7340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070815000749 FL Practitioner - NephrologyPractitioner - Internal Medicine 9335231794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Oklahoma College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlantic Nephrology IncGroup PAC ID 4688736580, 2 clinicians

Practice addresses (Care Compare)

210 Old Kings Rd S
Suite 900
Flagler Beach, FL 32136-4380
Phone (386) 338-3550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
ME94793FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Nephrology Inc Nephrology CurrentSince Jul 19, 2008 Accepting new patients
Daytona Beach Vascular Access, LLC PastSince May 28, 2023 Accepting new patients
Vinayak V Purandare MD PL Nephrology Past Accepting new patients
Volusia-Flagler Vascular Center LLC PastSince Feb 1, 2010 Accepting new patients

Locations

210 Old Kings Rd S
Ste 900
Flagler Beach, FL 32136
Phone (383) 338-3550

61 Memorial Medical Pkwy
Ste 3806
Palm Coast, FL 32164
Phone (386) 437-7340

Networks

  • FL HMO
  • FL HMO D-SNP
  • FL PPO
  • FL HMO C-SNP

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235001600000",
    "number": "1003842071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 MEMORIAL MEDICAL PKWY",
            "address_2": "SUITE 3806",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645981",
            "telephone_number": "386-437-7340",
            "fax_number": "386-437-7341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MEMORIAL MEDICAL PKWY",
            "address_2": "SUITE 3806",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645981",
            "telephone_number": "386-437-7340",
            "fax_number": "386-437-7341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "WILLIAM",
        "middle_name": "BONLORE",
        "credential": "PHD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2009-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME94793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.