Organization Active NPI

Jon Ferguson DO Corp

  • Nephrology Physician
  • Chico, CA
National Provider Identifier
1013257674
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
20A11757 Issued in CA
Legal business name
JON FERGUSON DO CORP
Practice address
3011 Ceres Ave
Ste 100
Chico, CA 95973-5635
Phone
(530) 899-7090
Fax
(530) 899-2765
NPI assigned
Feb 19, 2013
Last updated
Feb 19, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Authorized official

Name
Jon E Ferguson, DONPI 1902018294
Title
President
Phone
(530) 899-7090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 20A11757 CA Primary

Addresses

Primary practice location

3011 Ceres Ave
Ste 100
Chico, CA 95973-5635

Mailing address

3011 Ceres Ave
Ste 100
Chico, CA 95973-5635
Phone (530) 899-7090

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130712000649 CA Part B Supplier - Clinic/Group Practice 5496995565 Receives reassigned benefits from 1 practitioner
Practice locations: Chico, CA

National Provider Directory

National Provider Directory

Locations

3011 Ceres Ave
Ste 100
Chico, CA 95973
Phone (530) 332-3815

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1361232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361232000000",
    "number": "1013257674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 CERES AVE",
            "address_2": "STE 100",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959735635",
            "telephone_number": "530-899-7090",
            "fax_number": "530-899-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 CERES AVE",
            "address_2": "STE 100",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959735635",
            "telephone_number": "530-899-7090",
            "fax_number": "530-899-2765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JON FERGUSON DO CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-19",
        "last_updated": "2013-02-19",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-899-7090",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "20A11757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.