Kelli Ensley Ferguson, CNA II

Primary specialty

Technician/TechnologistTaxonomy code 156F00000X

License

71763 Issued in NC

Practice address

2825 Randolph Rd
Charlotte, NC 28211-1018

Phone

(704) 377-1647

NPI assigned

Mar 27, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelli Nicole Ensley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1033746011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 BLAIR LN APT B",
            "city": "BESSEMER CITY",
            "state": "NC",
            "postal_code": "280169300",
            "telephone_number": "704-913-8715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111018",
            "telephone_number": "704-377-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "KELLI",
        "middle_name": "ENSLEY",
        "name_prefix": "Ms.",
        "credential": "CNA II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": "NC",
            "license": "71763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLI",
            "last_name": "ENSLEY",
            "middle_name": "NICOLE",
            "credential": "CNA I",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Meghan Kate Ferer
• Nathan Patrick Fergus, M.D.
• Bailee Ryan Ferguson
• Diane McLaughlin Ferguson, CCC-SLP
• Jennifer Marie Ferguson
• Melissa A Ferguson, OT
• Micheal Javon Ferguson, LCAS-P, LCSW-P
• Michelle Ferguson, CCC/SLP
• Toni Renee Ferguson
• Stephanie Dawn Ferlic, FNP

• Technician/Technologist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Technician/Technologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.